Is R19.4 a billable ICD-10-CM code?

Yes. R19.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R19.4 sit in the tabular list?

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the digestive system and abdomen (R10-R19).

What cannot be coded together with R19.4?

R19.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R19.4 (R19) and apply to it just the same.

R19.4

R19.4 — Change in bowel habit

Billable / specific codeICD-10-CM

R19.4 is a billable, specific ICD-10-CM code for change in bowel habit. 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.

constipation (K59.0-)
functional diarrhea (K59.1)

Excludes1 inherited from the categories above R19.4

These are not written on R19.4, but they bind it: a note on a category applies to every code beneath it. Billing R19.4 with anything listed here is a denial.

Written on R19 — Other symptoms and signs involving the digestive system and abdomen

acute abdomen (R10.0)

Other codes that can never be billed with R19.4

These codes carry an Excludes1 note pointing at R19.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R19.4 alone.

K59Other functional intestinal disorders

Risk adjustment

R19.4 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

R19.4 is named in 6 Medicare coverage policies — 6 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
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

How R19.4 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 R19.4.

Change›bowel habit

Code history

R19.4 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share R19. If R19.4 is not quite right, the correct code is usually one of these.

Questions about R19.4

Is R19.4 a billable ICD-10-CM code?: Yes. R19.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R19.4 sit in the tabular list?: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), in the block Symptoms and signs involving the digestive system and abdomen (R10-R19).
What cannot be coded together with R19.4?: R19.4 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above R19.4 (R19) and apply to it just the same.