K92.1 ICD-10-CM Code: Melena

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K92.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on K92.1 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for K92.1

MedCoder structured workflow — derived from this code’s own official record

Before you code K92.1

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with K92.1. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support a condition named in K92.1’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewR19.5

Consider K92.1. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes1 — check before selecting K92.1(2 notes)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with K92.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareR19.5

  See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (5)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Abnormal, abnormality, abnormalities, stool (color) (contents) (mucus), bloody
• Blood, in, feces
• Diarrhea, diarrheal (disease) (infantile) (inflammatory), with, melena
• Hematochezia
• Melena

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Don’t confuse K92.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K92.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• R19.5— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of occult blood in feces moves the case to R19.5; the two are not reported together unless documented as unrelated.

  Full comparison: K92.1 vs R19.5 →

• P54.0— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of neonatal gastrointestinal hemorrhage moves the case to P54.0; the two are not reported together unless documented as unrelated.

  Full comparison: K92.1 vs P54.0 →

• P54.3— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of neonatal gastrointestinal hemorrhage moves the case to P54.3; the two are not reported together unless documented as unrelated.

  Full comparison: K92.1 vs P54.3 →

• K92.2— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Gastrointestinal hemorrhage, unspecified” takes K92.2; specificity in the record moves it back here.

  Full comparison: K92.1 vs K92.2 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name K92.1 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes across 2 chapters: K62.5 — Hemorrhage of anus and rectum, R19.5 — Other fecal abnormalities.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 11 Excludes2 notes: R10 — Abdominal and pelvic pain, R10-R19 — Symptoms and signs involving the digestive system and abdomen (R10-R19), R11 — Nausea and vomiting, R12 — Heartburn, R13 — Aphagia and dysphagia, R14 — Flatulence and related conditions, R15 — Fecal incontinence, R16 — Hepatomegaly and splenomegaly, not elsewhere classified, R17 — Unspecified jaundice, R18 — Ascites, R19 — Other symptoms and signs involving the digestive system and abdomen.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 72 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 377 (MDC 06), DRG 378 (MDC 06), DRG 379 (MDC 06), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG021 — Gastrointestinal hemorrhage (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

K29.71 — Gastritis, unspecified, with bleeding, K29.81 — Duodenitis with bleeding, K29.91 — Gastroduodenitis, unspecified, with bleeding, K31.811 — Angiodysplasia of stomach and duodenum with bleeding, K55.21 — Angiodysplasia of colon with hemorrhage, K57.01 — Diverticulitis of small intestine with perforation and abscess with bleeding, K57.11 — Diverticulosis of small intestine without perforation or abscess with bleeding, K57.13 — Diverticulitis of small intestine without perforation or abscess with bleeding, K57.21 — Diverticulitis of large intestine with perforation and abscess with bleeding, K57.31 — Diverticulosis of large intestine without perforation or abscess with bleeding, K57.33 — Diverticulitis of large intestine without perforation or abscess with bleeding, K57.41 — Diverticulitis of both small and large intestine with perforation and abscess with bleeding, K57.51 — Diverticulosis of both small and large intestine without perforation or abscess with bleeding, K57.53 — Diverticulitis of both small and large intestine without perforation or abscess with bleeding, K57.81 — Diverticulitis of intestine, part unspecified, with perforation and abscess with bleeding, K57.91 — Diverticulosis of intestine, part unspecified, without perforation or abscess with bleeding, K57.93 — Diverticulitis of intestine, part unspecified, without perforation or abscess with bleeding, K62.5 — Hemorrhage of anus and rectum, K92.0 — Hematemesis, K92.2 — Gastrointestinal hemorrhage, unspecified, +51 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Gastrointestinal hemorrhage).

K51.411 — Inflammatory polyps of colon with rectal bleeding, K51.511 — Left sided colitis with rectal bleeding, K51.811 — Other ulcerative colitis with rectal bleeding, K51.911 — Ulcerative colitis, unspecified with rectal bleeding, K55.21 — Angiodysplasia of colon with hemorrhage, K57.01 — Diverticulitis of small intestine with perforation and abscess with bleeding, K57.11 — Diverticulosis of small intestine without perforation or abscess with bleeding, K57.13 — Diverticulitis of small intestine without perforation or abscess with bleeding, K57.21 — Diverticulitis of large intestine with perforation and abscess with bleeding, K57.31 — Diverticulosis of large intestine without perforation or abscess with bleeding, K57.33 — Diverticulitis of large intestine without perforation or abscess with bleeding, K57.41 — Diverticulitis of both small and large intestine with perforation and abscess with bleeding, K57.51 — Diverticulosis of both small and large intestine without perforation or abscess with bleeding, K57.53 — Diverticulitis of both small and large intestine without perforation or abscess with bleeding, K57.81 — Diverticulitis of intestine, part unspecified, with perforation and abscess with bleeding, K57.91 — Diverticulosis of intestine, part unspecified, without perforation or abscess with bleeding, K57.93 — Diverticulitis of intestine, part unspecified, without perforation or abscess with bleeding, K62.5 — Hemorrhage of anus and rectum, K92.0 — Hematemesis, K92.2 — Gastrointestinal hemorrhage, unspecified, +41 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Abnormal, abnormality, abnormalities”, “Blood”, “Diarrhea, diarrheal”, …; these codes share that main term but sit in a different category of the Tabular List.

K27.4 — Chronic or unspecified peptic ulcer, site unspecified, with hemorrhage (with ulcer - code by site under Ulcer, with hemorrhage), K31.83 — Achlorhydria (achlorhydric), K52.1 — Toxic gastroenteritis and colitis (toxic), K52.29 — Other allergic and dietetic gastroenteritis and colitis (allergic), K52.89 — Other specified noninfective gastroenteritis and colitis (cachectic NEC), K52.9 — Noninfective gastroenteritis and colitis, unspecified (chronic), K59.1 — Functional diarrhea (neurogenic), K90.1 — Tropical sprue (hill), K91.1 — Postgastric surgery syndromes (postvagotomy), K91.89 — Other postprocedural complications and disorders of digestive system (functional, following gastrointestinal surgery), L67.8 — Other hair color and hair shaft abnormalities (hair, specified NEC), L67.9 — Hair color and hair shaft abnormality, unspecified (hair), M05.A — Abnormal rheumatoid factor and anti-citrullinated protein antibody with rheumatoid arthritis (rheumatoid factor and anti-citrullinated protein antibody, with rheumatoid arthritis), M26.30 — Unspecified anomaly of tooth position of fully erupted tooth or teeth (direction, teeth, fully erupted), M26.51 — Abnormal jaw closure (jaw closure), N05.0 — Unspecified nephritic syndrome with minor glomerular abnormality (glomerular, minor), O02.0 — Blighted ovum and nonhydatidiform mole (mole), O02.89 — Other abnormal products of conception (product of conception, specified type NEC), O02.9 — Abnormal product of conception, unspecified (product of conception), O08.1 — Delayed or excessive hemorrhage following ectopic and molar pregnancy (dyscrasia, with, molar pregnancy), +306 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Fecal Occult Blood Test (FOBT), Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of K92.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K92.1 with these 10 related codes in Claim Check

Hierarchy

• K00-K95 — Chapter 11: Diseases of the Digestive System (K00-K95) (K00-K95)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K90-K95 — Other diseases of the digestive system[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Excludes1

• R19.5 — Other fecal abnormalities[Excludes1]: “occult blood in feces (R19.5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

• K62.5 — Hemorrhage of anus and rectum[Excludes1]: “melena (K92.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R19.5 — Other fecal abnormalities[Excludes1]: “melena (K92.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes (11)

• R10 — Abdominal and pelvic pain[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R10-R19 — Symptoms and signs involving the digestive system and abdomen (R10-R19)[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R11 — Nausea and vomiting[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R12 — Heartburn[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R13 — Aphagia and dysphagia[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R14 — Flatulence and related conditions[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R15 — Fecal incontinence[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R16 — Hepatomegaly and splenomegaly, not elsewhere classified[Excludes2]: “gastrointestinal hemorrhage (K92.0-K92.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• and 3 more

Clinical classification (CCSR)

• DIG021 — Gastrointestinal hemorrhage[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 377 — GASTROINTESTINAL HEMORRHAGE WITH MCC[MS-DRG]: “GASTROINTESTINAL HEMORRHAGE WITH MCC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 378 — GASTROINTESTINAL HEMORRHAGE WITH CC[MS-DRG]: “GASTROINTESTINAL HEMORRHAGE WITH CC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 379 — GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC[MS-DRG]: “GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 06 — Diseases and Disorders of the Digestive System[MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,744 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
• MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Abnormal, abnormality, abnormalities, stool (color) (contents) (mucus), bloody[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Blood, in, feces[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Diarrhea, diarrheal (disease) (infantile) (inflammatory), with, melena[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Hematochezia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Melena[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

• K92 — Other diseases of digestive system[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K92.0 — Hematemesis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K92.2 — Gastrointestinal hemorrhage, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K92.8 — Other specified diseases of the digestive system[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K92.81 — Gastrointestinal mucositis (ulcerative)[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K92.89 — Other specified diseases of the digestive system[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K92.9 — Disease of digestive system, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K92.1 in its code family, with their registry titles.

• K92 — Other diseases of digestive system
• K92.0 — Hematemesis
• K92.2 — Gastrointestinal hemorrhage, unspecified
• K92.8 — Other specified diseases of the digestive system
• K92.81 — Gastrointestinal mucositis (ulcerative)
• K92.89 — Other specified diseases of the digestive system
• K92.9 — Disease of digestive system, unspecified

View all codes in the K92 family