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.

Check R19.5 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.

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

Excludes1 inherited from the categories above R19.5

A category’s note binds every code beneath it.

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 R19.5

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

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

Risk adjustment

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

Medicare coverage

R19.5 is named in 20 Medicare coverage policies: 20 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A55937Billing and Coding: Diagnostic Colonoscopy
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A56461Billing and Coding: Endoscopy by Capsule

Alphabetic index entries that lead here

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

Code history

Unchanged in every release from FY2024 to FY2027.