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

ICD-10 D12.5

Billable / Specific

Benign neoplasm of sigmoid colon

D12
Block
0
Synonyms
353
LCDs
16
Payer Policies
28
Linked CPTs

About ICD-10-CM D12.5

ICD-10-CM code D12.5 represents Benign neoplasm of sigmoid colon. This is a billable/specific code in the Neoplasms chapter (block D12). The 2026 edition of ICD-10-CM D12.5 became effective on October 1, 2025.

Medicare LCD Coverage for D12.5

Local Coverage Determinations (LCDs) from CMS MACs that list D12.5 as a covered diagnosis.

353 LCDs

Showing top 10 of 353 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45398 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D12.5.

16 policies

5 Medicare

Billing and Coding: Diagnostic Colonoscopy
Policy ID: ART-55937
Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Policy ID: ART-56394
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Endoscopy by Capsule
Policy ID: ART-56461

CPT Codes Commonly Billed with D12.5

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

28 linkages
  • 45380 Colonoscopy with biopsy — colon polyp, neoplasm of colon, melena, iron deficiency anemia, screening, personal hx polyps, UC, occult blood Gastroenterology
  • 45385 Colonoscopy with polypectomy snare — colon polyps all sites, screening, personal/family hx polyps/cancer Gastroenterology
  • 45384 Colonoscopy with hot biopsy forceps polypectomy — small polyp removal Gastroenterology
  • 44408 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 45379 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44406 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 45390 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 45392 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44394 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD
  • 44402 CMS LCD: Billing and Coding: Diagnostic Colonoscopy CMS LCD

Convert D12.5 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
D12.5 2113 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 D12.5, Billing FAQ

Is ICD-10 code D12.5 billable? +

Yes, D12.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with D12.5? +

Procedures frequently paired with D12.5 include: 45380, 45385, 45384, 44408, 45379.

What ICD-9 codes does D12.5 map to? +

Per CMS GEMs, D12.5 maps to ICD-9 codes: 2113. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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