Partial List of ICD-9-CM Codes Indicating High Risk
Listed below are some examples of diagnoses that meet the high risk criteria for colorectal cancer. This is not an all-inclusive list. There may be more instances of conditions which may be coded and could be at the medical directors’ discretion.
• Personal History
o V10.05 – Personal history of malignant neoplasm of large intestine
o V10.06 – Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus
• Chronic Digestive Disease Condition
o 555.0 – Regional enteritis of small intestine
o 555.1 – Regional enteritis of large intestine
o 555.2 – Regional enteritis of small intestine with large intestine
o 555.9 – Regional enteritis of unspecified site
o 556.0 – Ulcerative (chronic) enterocolitis
o 556.1 – Ulcerative (chronic) ileocolitis
o 556.2 – Ulcerative (chronic) proctitis
o 556.3 – Ulcerative (chronic) proctosigmoiditis
o 556.8 – Other ulcerative colitis
o 556.9 – Ulcerative colitis, unspecified (nonspecific PDX on the MCE)
• Inflammatory Bowel
o 558.2 – Toxic gastroenteritis and colitis
o 558.9 – Other and unspecified noninfectious gastroenteritis and colitis
Characteristics of the High Risk Individual
An individual at high risk for developing colorectal cancer has one or more of the following:
A close relative (sibling, parent, or child) who has had colorectal cancer or an adenomatous polyp;
A family history of familial adenomatous polyposis;
A family history of hereditary nonpolyposis colorectal cancer;
A personal history of colorectal cancer;
A personal history of adenomatous polyps;
Inflammatory bowel disease, including Crohn’s Disease, and ulcerative colitis.
