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.
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