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

ICD-10 K62.1

Billable / Specific

Rectal polyp

K62
Block
0
Synonyms
220
LCDs
10
Payer Policies
3
Linked CPTs

About ICD-10-CM K62.1

ICD-10-CM code K62.1 represents Rectal polyp. This is a billable/specific code in the Digestive System chapter (block K62). The 2026 edition of ICD-10-CM K62.1 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with K62.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • adenomatous polyp (D12.8)

Medicare LCD Coverage for K62.1

Local Coverage Determinations (LCDs) from CMS MACs that list K62.1 as a covered diagnosis.

220 LCDs

Showing top 10 of 220 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45398 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44392 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45386 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45378 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44390 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45393 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44394 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44401 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K62.1.

10 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: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632
Billing and Coding: Diagnostic and Therapeutic Colonoscopy
Policy ID: ART-57342

2 Aetna

Colonoscopy, Colorectal Cancer Screening, and Related Procedures
Policy ID: CPB-0516
Capsule Endoscopy
Policy ID: CPB-0588

CPT Codes Commonly Billed with K62.1

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

3 linkages
  • 45385 Colonoscopy polypectomy — polyps found Gastroenterology
  • 45378 Diagnostic colonoscopy — colorectal screening, family hx colon cancer, polyp, melena, iron def anemia, diverticulosis, ulcerative colitis, Crohn, occult blood, rectal polyp, weight loss, IBS Gastroenterology
  • 0184T CMS LCD: Billing and Coding: Transanal Endoscopic Surgery (TES) CMS LCD

Convert K62.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
K62.1 5690 10000

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

ICD-10 K62.1, Billing FAQ

Is ICD-10 code K62.1 billable? +

Yes, K62.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for K62.1? +

Type 1 Excludes (never code together with K62.1): adenomatous polyp (D12.8)

What CPT codes are commonly billed with K62.1? +

Procedures frequently paired with K62.1 include: 45385, 45378, 0184T.

What ICD-9 codes does K62.1 map to? +

Per CMS GEMs, K62.1 maps to ICD-9 codes: 5690. 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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