Is K92.1 a billable ICD-10-CM code?

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

Where does K92.1 sit in the tabular list?

Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).

What cannot be coded together with K92.1?

K92.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

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.

Excludes1 — never code together

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

occult blood in feces (R19.5)

Other codes that can never be billed with K92.1

These codes carry an Excludes1 note pointing at K92.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K92.1 alone.

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

Risk adjustment

K92.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

K92.1 is named in 27 Medicare coverage policies — 27 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

How K92.1 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K92.1.

Hematochezia
Melena
Abnormal, abnormality, abnormalities›stool›bloody
Blood›in›feces

Related codes at this level

Codes that share K92. If K92.1 is not quite right, the correct code is usually one of these.

Questions about K92.1

Is K92.1 a billable ICD-10-CM code?: Yes. K92.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K92.1 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).
What cannot be coded together with K92.1?: K92.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.