Skip to main content

P54.1 ICD-10-CM Code: Neonatal melena

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
8 Excludes1

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P54.1 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 P54.1 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Coder workflow for P54.1

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

Before you code P54.1

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with P54.1. 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 P54.1’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.

    ReviewP78.2, P50, P26, Q44.3, E80.5, E80.6

Consider P54.1. 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 P54.1(8 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with P54.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareP78.2, P50, P26, Q44.3, E80.5, E80.6

    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

Documentation: Both the condition P54.1 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewP78.2, P50, P26, Q44.3, E80.5, E80.6

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.

Code Overview

Neonatal melena is a billable ICD-10-CM diagnosis code (P54.1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

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.

Verify Before Coding

  • MCC 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 P54.1 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 3 Excludes1 notes across 3 chapters: K92 — Other diseases of digestive system, P78 — Other perinatal digestive system disorders, 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 21 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, R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity (via P54.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via P54.-), R71 — Abnormality of red blood cells (via P54.-), R73 — Elevated blood glucose level (via P54.-), R74 — Abnormal serum enzyme levels (via P54.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via P54.-), R76 — Other abnormal immunological findings in serum (via P54.-), R77 — Other abnormalities of plasma proteins (via P54.-), R78 — Findings of drugs and other substances, not normally found in blood (via P54.-), +1 more.

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: MCC — Major 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 44 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: 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):PNL011 — Hemorrhagic and hematologic disorders of newborn (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 MCC — 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.

P50.0 — Newborn affected by intrauterine (fetal) blood loss from vasa previa, P50.1 — Newborn affected by intrauterine (fetal) blood loss from ruptured cord, P50.2 — Newborn affected by intrauterine (fetal) blood loss from placenta, P50.3 — Newborn affected by hemorrhage into co-twin, P50.4 — Newborn affected by hemorrhage into maternal circulation, P50.5 — Newborn affected by intrauterine (fetal) blood loss from cut end of co-twin's cord, P50.8 — Newborn affected by other intrauterine (fetal) blood loss, P50.9 — Newborn affected by intrauterine (fetal) blood loss, unspecified, P53 — Hemorrhagic disease of newborn, P54.0 — Neonatal hematemesis, P54.2 — Neonatal rectal hemorrhage, P54.3 — Other neonatal gastrointestinal hemorrhage, P54.4 — Neonatal adrenal hemorrhage, P54.6 — Neonatal vaginal hemorrhage, P54.8 — Other specified neonatal hemorrhages, P54.9 — Neonatal hemorrhage, unspecified, P60 — Disseminated intravascular coagulation of newborn, P61.0 — Transient neonatal thrombocytopenia, P61.1 — Polycythemia neonatorum, P61.2 — Anemia of prematurity, +23 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Hemorrhagic and hematologic disorders of newborn).

P52.21 — Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn, P52.22 — Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn, P52.3 — Unspecified intraventricular (nontraumatic) hemorrhage of newborn, P52.4 — Intracerebral (nontraumatic) hemorrhage of newborn, P52.5 — Subarachnoid (nontraumatic) hemorrhage of newborn, P52.6 — Cerebellar (nontraumatic) and posterior fossa hemorrhage of newborn, P52.8 — Other intracranial (nontraumatic) hemorrhages of newborn, P52.9 — Intracranial (nontraumatic) hemorrhage of newborn, unspecified, P53 — Hemorrhagic disease of newborn, P54.0 — Neonatal hematemesis, P54.2 — Neonatal rectal hemorrhage, P54.3 — Other neonatal gastrointestinal hemorrhage, P54.4 — Neonatal adrenal hemorrhage, P54.5 — Neonatal cutaneous hemorrhage, P54.6 — Neonatal vaginal hemorrhage, P54.8 — Other specified neonatal hemorrhages, P54.9 — Neonatal hemorrhage, unspecified, P60 — Disseminated intravascular coagulation of newborn, P61.0 — Transient neonatal thrombocytopenia, P61.1 — Polycythemia neonatorum, +20 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Melena”; 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), K92.1 — Melena, P78.2 — Neonatal hematemesis and melena due to swallowed maternal blood (due to swallowed maternal blood)

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.

Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of P54.1 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 P54.1 with these 12 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

Referenced by Excludes2 notes (21)

Clinical classification (CCSR)

MS-DRG Grouper

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”— CMS MS-DRG Definitions Manual (Appendix C) · 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

Index entries

  • Melena, newborn, neonatal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (9)

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
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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "P54.1 — Neonatal melena." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/p54.1-neonatal-melena

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Neonatal melena

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P54.1 in its code family, with their registry titles.

View all codes in the P54 family