K92.1 vs R19.5
K92.1 and R19.5 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on K92.1
occult blood in feces (R19.5)
K92.1
Melena
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K90-K95
Indexed under
- Hematochezia
- Melena
- Abnormal, abnormality, abnormalities › stool › bloody
- Blood › in › feces
- Diarrhea, diarrheal › with › melena (disease) (infantile) (inflammatory)
R19.5
Other fecal abnormalities
Billable
- Chapter 18
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
- Section
- R10-R19
Use when the record says
- Abnormal stool color
- Bulky stools
- Mucus in stools
- Occult blood in feces
- Occult blood in stools
Indexed under
- Abnormal, abnormality, abnormalities › feces
- Abnormal, abnormality, abnormalities › stool
- Blood › occult in feces
- Bulky › stools
- Fat › in stool
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027