FY2027
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Excludes1 pair

R19.5 vs R85-

R19.5 and R85 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 R85
fecal abnormalities (R19.5)
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
R85

Abnormal findings in specimens from digestive organs and abdominal cavity

Not billable
Chapter 18
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
Section
R83-R89
Use when the record says
  • abnormal findings in peritoneal fluid
  • abnormal findings in saliva

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