K92.1

K92.1: Melena

Billable / specific codeICD-10-CM

K92.1 is a billable, specific ICD-10-CM code for melena. It is valid for submission on a claim.

Check K92.1 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

occult blood in feces (R19.5)

Excludes1 inherited from the categories above K92.1

A category’s note binds every code beneath it.

Written on K92: Other diseases of digestive system

neonatal gastrointestinal hemorrhage (P54.0-P54.3)

Other codes that can never be billed with K92.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

K62.5Hemorrhage of anus and rectum
R19.5Other fecal abnormalities

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

K92.1 is named in 27 Medicare coverage policies: 27 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55937Billing and Coding: Diagnostic Colonoscopy
A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56421Billing and Coding: CT of the Abdomen and Pelvis

Alphabetic index entries that lead here

Hematochezia
Melena
Abnormal, abnormality, abnormalities›stool›bloody
Blood›in›feces
Diarrhea, diarrheal›with›melena

Code history

Unchanged in every release from FY2024 to FY2027.