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

ICD-10 D12.6

Billable / Specific

Benign neoplasm of colon, unspecified

D12
Block
3
Synonyms
253
LCDs
12
Payer Policies
5
Linked CPTs

About ICD-10-CM D12.6

ICD-10-CM code D12.6 represents Benign neoplasm of colon, unspecified. This is a billable/specific code in the Neoplasms chapter (block D12). The 2026 edition of ICD-10-CM D12.6 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under D12.6. Per CMS ICD-10-CM Tabular 2026.

  • Adenomatosis of colon
  • Benign neoplasm of large intestine NOS
  • Polyposis (hereditary) of colon

Type 2 Excludes

Not included here, the excluded code is not part of D12.6, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • inflammatory polyp of colon (K51.4-)

Medicare LCD Coverage for D12.6

Local Coverage Determinations (LCDs) from CMS MACs that list D12.6 as a covered diagnosis.

253 LCDs

Showing top 10 of 253 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: Genetic Testing for Lynch Syndrome
Article ID: 57450, Effective: 2025-10-01 00:00:00, 113 covered, 1 non-covered
CPT 0238U →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing D12.6.

12 policies

5 Medicare

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: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632

2 Aetna

Capsule Endoscopy
Policy ID: CPB-0588
Polymerase Chain Reaction Testing: Selected Indications
Policy ID: CPB-0650

CPT Codes Commonly Billed with D12.6

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

5 linkages
  • 45385 Colonoscopy polypectomy — polyps found Gastroenterology
  • 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
  • 45381 Colonoscopy with directed submucosal injection — polyp removal facilitation, same dx as polypectomy Gastroenterology
  • 45384 Colonoscopy with hot biopsy forceps polypectomy — small polyp removal Gastroenterology

Convert D12.6 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
D12.6 2113 10000

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

ICD-10 D12.6, Billing FAQ

Is ICD-10 code D12.6 billable? +

Yes, D12.6 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to D12.6? +

ICD-10 D12.6 includes: Adenomatosis of colon; Benign neoplasm of large intestine NOS; Polyposis (hereditary) of colon.

What codes are Type 2 Excludes for D12.6? +

Type 2 Excludes (may be coded together when both conditions exist): inflammatory polyp of colon (K51.4-)

What CPT codes are commonly billed with D12.6? +

Procedures frequently paired with D12.6 include: 45385, 45380, 45385, 45381, 45384.

What ICD-9 codes does D12.6 map to? +

Per CMS GEMs, D12.6 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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