Determining High Risk for Developing Colorectal Cancer (Rev. 1, 10-01-03)

by  Jared Staheli
July 5th, 2015

A. 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 adenomatous polyps;

• A personal history of colorectal cancer; or

• Inflammatory bowel disease, including Crohn’s Disease, and ulcerative colitis.

B. 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 considered high risk at the medical directors’ discretion.

Personal History

V10.05 Personal history of malignant neoplasm of large intestine
V10.06 Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus

Chronic Digestive Disease Condition:

555.0 Regional enteritis of small intestine
555.1 Regional enteritis of large intestine
555.2 Regional enteritis of small intestine with large intestine
555.9 Regional enteritis of unspecified site
556.0 Ulcerative (chronic) enterocolitis
556.1 Ulcerative (chronic) ileocolitis
556.2 Ulcerative (chronic) proctitis
556.3 Ulcerative (chronic) proctosigmoiditis
556.8 Other ulcerative colitis
556.9 Ulcerative colitis, unspecified (non-specific PDX on the MCE)

Inflammatory Bowel:

558.2 Toxic gastroenteritis and colitis
558.9 Other and unspecified non-infectious gastroenteritis and colitis


Determining High Risk for Developing Colorectal Cancer (Rev. 1, 10-01-03). (2015, July 5). Find-A-Code Articles. Retrieved from

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