FY2027
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Excludes1 pair

K92.1 vs R19.5

K92.1 and R19.5 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

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
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 (color) (contents) (mucus)
  • Abnormal, abnormality, abnormalities › stool (color) (contents) (mucus)
  • 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