ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 D12

Non-Billable Header

Benign neoplasm of colon, rectum, anus and anal canal

D12
Block
0
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM D12

ICD-10-CM code D12 represents Benign neoplasm of colon, rectum, anus and anal canal. This is a non-billable header code in the Neoplasms chapter (block D12). The 2026 edition of ICD-10-CM D12 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Type 2 Excludes

Not included here, the excluded code is not part of D12, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • benign carcinoid tumors of the large intestine and rectum (D3A.02-)
  • polyp of colon NOS (K63.5)

Medicare LCD Coverage for D12

Local Coverage Determinations (LCDs) from CMS MACs that list D12 as a covered diagnosis.

No Medicare LCDs reference D12 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D12.

No commercial payer policies reference D12 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but D12 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with D12

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for D12

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

ICD-10 D12, Billing FAQ

Is ICD-10 code D12 billable? +

No, D12 is a non-billable header code. Use a more specific child code from block D12 when submitting claims.

What codes are Type 2 Excludes for D12? +

Type 2 Excludes (may be coded together when both conditions exist): benign carcinoid tumors of the large intestine and rectum (D3A.02-); polyp of colon NOS (K63.5)

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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