Is R19.5 a billable ICD-10-CM code?

Yes. R19.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does R19.5 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 R19.5?

R19.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

R19.5

R19.5 — Other fecal abnormalities

Billable / specific codeICD-10-CM

R19.5 is a billable, specific ICD-10-CM code for other fecal abnormalities. 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.

melena (K92.1)
neonatal melena (P54.1)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Abnormal stool color
Bulky stools
Mucus in stools
Occult blood in feces
Occult blood in stools

Other codes that can never be billed with R19.5

These codes carry an Excludes1 note pointing at R19.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading R19.5 alone.

R85Abnormal findings in specimens from digestive organs and abdominal cavity
K92.1Melena

Risk adjustment

R19.5 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

R19.5 is named in 20 Medicare coverage policies — 20 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
A56461Billing and Coding: Endoscopy by Capsule

How R19.5 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 R19.5.

Abnormal, abnormality, abnormalities›feces(color) (contents) (mucus)
Abnormal, abnormality, abnormalities›stool(color) (contents) (mucus)
Blood›occult in feces
Bulky›stools
Fat›in stool
Mucus›in stool
Occult›blood in feces(stools)
Abnormal, abnormality, abnormalities›stool›guaiac positive
Pus›in›stool
Blood›in›feces›occult

Related codes at this level

Codes that share R19. If R19.5 is not quite right, the correct code is usually one of these.

Questions about R19.5

Is R19.5 a billable ICD-10-CM code?: Yes. R19.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does R19.5 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 R19.5?: R19.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.