What is the ICD-10 code for abnormal Cologuard?

The ICD-10 code for abnormal Cologuard is R19.5, which is used for other fecal abnormalities.

How should a positive Cologuard be documented?

Document the positive Cologuard result with the test date and link it to the need for a colonoscopy.

ICD-10 Coding for Abnormal Cologuard(R19.5, K63.5, R85.89)

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Learn about the ICD-10 coding for abnormal Cologuard results, including primary codes, documentation requirements, and billing considerations.

Also known as:

Positive CologuardAbnormal FIT-DNA Test

Related ICD-10 Code Ranges

Complete code families applicable to Abnormal Cologuard

R00-R99Primary Range

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
R19.5	Other fecal abnormalities	Use as the primary code for colonoscopy following a positive Cologuard result in asymptomatic patients.	Documented positive Cologuard test result Reason for colonoscopy explicitly linked to positive Cologuard
Z12.11	Encounter for screening for malignant neoplasm of colon	Use as a secondary code when the colonoscopy is part of a screening process.	Patient is asymptomatic Colonoscopy is part of routine screening
K63.5	Polyp of colon	Use as primary if a polyp is found during colonoscopy following a positive Cologuard.	Polyp confirmed during colonoscopy

Primary ICD-10-CM Codes

Other fecal abnormalities

R19.5Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Abnormal tumor markersR85.89

Documentation & Coding Risks

Avoid these common issues when documenting Abnormal Cologuard.

Vague documentation of test results

Impact

Clinical: May lead to inappropriate follow-up care., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.

Mitigation

Use specific test names and dates, Link test results to follow-up procedures

Using R85.89 instead of R19.5 for positive Cologuard

Impact

Reimbursement: May lead to claim denials or incorrect reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation

Use R19.5 for fecal abnormalities related to positive Cologuard.

Incorrect coding of follow-up procedures

Impact

Using incorrect codes for colonoscopy after positive Cologuard.

Mitigation

Ensure R19.5 is used as primary with appropriate modifiers.

Normal colonoscopy after positive Cologuard

Document Abnormal Cologuard in one step.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with R19.5.

Primary Code

R19.5

Other fecal abnormalities

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ICD-10 codes4

Coding risks5

FAQs2

ICD-10 Coding for Abnormal Cologuard(R19.5, K63.5, R85.89)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for abnormal Cologuard?

How should a positive Cologuard be documented?

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