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v1.0.0
ICD-10 Guide
ICD-10 CodesR19.5

R19.5

Other fecal abnormalities

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R19.5 is a billable code used to indicate a diagnosis of other fecal abnormalities.

Key Diagnostic Point:

The ICD-10 code R19.5 is used to classify symptoms and signs related to fecal abnormalities that do not fall under more specific categories. This may include a variety of fecal irregularities such as changes in stool consistency, color, or frequency that are not otherwise specified. Patients may present with symptoms such as diarrhea, constipation, or unusual stool characteristics, which can indicate underlying gastrointestinal disorders. Common causes of fecal abnormalities include infections, inflammatory bowel disease, dietary changes, malabsorption syndromes, and certain medications. The diagnostic approach typically involves a thorough patient history, physical examination, and may include laboratory tests such as stool analysis, imaging studies, or endoscopy to identify the underlying cause. Accurate coding requires careful documentation of the patient's symptoms and any relevant clinical findings to ensure appropriate treatment and follow-up.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Overlap with other gastrointestinal codes
  • Need for detailed documentation of symptoms
  • Potential for misclassification with similar codes

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the nature of fecal abnormalities
  • Misuse of related codes leading to upcoding or downcoding
  • Lack of supporting clinical findings in the medical record

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including dietary habits and bowel movement patterns, along with any associated symptoms.

Common Clinical Scenarios

Patients presenting with unexplained changes in bowel habits, abdominal pain, or weight loss.

Billing Considerations

Ensure that all relevant clinical findings are documented to support the diagnosis and coding.

Emergency Medicine

Documentation Requirements

Acute care documentation must include a rapid assessment of symptoms and any immediate interventions.

Common Clinical Scenarios

Patients with acute diarrhea or constipation presenting with dehydration or abdominal distress.

Billing Considerations

Document any acute interventions performed and the patient's response to treatment.

Coding Guidelines

Inclusion Criteria

Use R19.5 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the fecal abnormality is not classified elsewhere
  • Document the specific symptoms and clinical findings that justify the use of R19

Exclusion Criteria

Do NOT use R19.5 When
No specific exclusions found.

Related CPT Codes

45378CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

When fecal abnormalities are suspected to be due to structural issues.

Documentation Requirements

Indication for the procedure must be clearly documented.

Specialty Considerations

Gastroenterology specialists should ensure that all findings are documented for accurate coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gastrointestinal symptoms, including fecal abnormalities. R19.5 provides a catch-all for symptoms that do not fit neatly into other categories, but it requires careful documentation to avoid misclassification.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gastrointestinal symptoms, including fecal abnormalities. R19.5 provides a catch-all for symptoms that do not fit neatly into other categories, but it requires careful documentation to avoid misclassification.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use R19.5?

Use R19.5 when a patient presents with fecal abnormalities that do not fit into more specific categories and when the underlying cause is not yet determined.