R19.12 ICD-10-CM Code: Hyperactive bowel sounds

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R19.12 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 R19.12 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for R19.12

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

Before you code R19.12

1. Check whether an established diagnosis that explains this sign or symptom is documented. If one is, review whether the documented diagnosis changes the coding pathway: a symptom that is integral to a confirmed diagnosis is not reported separately, while one not routinely associated with it may be. Signs and symptoms are reported when no definitive diagnosis is established (Guidelines I.B.4, I.B.5, I.B.6, I.C.18.b).

   Guide: Symptom code vs confirmed diagnosis →

2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with R19.12. 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. Is an established diagnosis that explains this sign or symptom documented?
   Yes → Review whether the documented diagnosis changes the coding pathway: a symptom integral to it is not reported separately.
   No → Continue — the sign or symptom code stands when no definitive diagnosis is established.
2. Does the documentation support a condition named in R19.12’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.

   ReviewR10.0

Consider R19.12. 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 R19.12(1 note)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with R19.12: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareR10.0

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

• Excludes2 — not part of R19.12(9 notes)

  Coding workflow: The conditions named in this note are not included in R19.12. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareQ40.0, K56, P76, K31.3, N94

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

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 (2)

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, bowel sounds, hyperactive
• Hyperactive, hyperactivity, bowel sounds

Don’t confuse R19.12 with…

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

The codes most likely to be picked instead of R19.12 — 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.

• R10.0— 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 acute abdomen moves the case to R10.0; the two are not reported together unless documented as unrelated.

  Full comparison: R19.12 vs R10.0 →

• Q40.0— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of congenital or infantile pylorospasm adds Q40.0; it is not part of this code and both may be reported when both are documented.

  Full comparison: R19.12 vs Q40.0 →

• K92.0— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of gastrointestinal hemorrhage adds K92.0; it is not part of this code and both may be reported when both are documented.

  Full comparison: R19.12 vs K92.0 →

• K92.2— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of gastrointestinal hemorrhage adds K92.2; it is not part of this code and both may be reported when both are documented.

  Full comparison: R19.12 vs K92.2 →

• K56— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of intestinal obstruction adds K56; it is not part of this code and both may be reported when both are documented.

  Full comparison: R19.12 vs K56 →

• P54.0— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of newborn gastrointestinal hemorrhage adds P54.0; it is not part of this code and both may be reported when both are documented.

  Full comparison: R19.12 vs P54.0 →

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

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 391 (MDC 06), DRG 392 (MDC 06).

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

Clinical classification (AHRQ CCSR):SYM006 — Abdominal pain and other digestive/abdomen signs and symptoms (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 category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Abdominal pain and other digestive/abdomen signs and symptoms).

R19.00 — Intra-abdominal and pelvic swelling, mass and lump, unspecified site, R19.01 — Right upper quadrant abdominal swelling, mass and lump, R19.02 — Left upper quadrant abdominal swelling, mass and lump, R19.03 — Right lower quadrant abdominal swelling, mass and lump, R19.04 — Left lower quadrant abdominal swelling, mass and lump, R19.05 — Periumbilic swelling, mass or lump, R19.06 — Epigastric swelling, mass or lump, R19.07 — Generalized intra-abdominal and pelvic swelling, mass and lump, R19.09 — Other intra-abdominal and pelvic swelling, mass and lump, R19.11 — Absent bowel sounds, R19.15 — Other abnormal bowel sounds, R19.2 — Visible peristalsis, R19.30 — Abdominal rigidity, unspecified site, R19.31 — Right upper quadrant abdominal rigidity, R19.32 — Left upper quadrant abdominal rigidity, R19.33 — Right lower quadrant abdominal rigidity, R19.34 — Left lower quadrant abdominal rigidity, R19.35 — Periumbilic abdominal rigidity, R19.36 — Epigastric abdominal rigidity, R19.37 — Generalized abdominal rigidity, +58 more

Same Index main term, other category

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

Q99.9 — Chromosomal abnormality, unspecified (autosomes), R00.2 — Palpitations (pulsations in neck), R00.8 — Other abnormalities of heart beat (heart, rate, specified NEC), R00.9 — Unspecified abnormalities of heart beat (heart, rate), R01.2 — Other cardiac sounds (heart, sounds NEC), R03.0 — Elevated blood-pressure reading, without diagnosis of hypertension (blood pressure, elevated), R03.1 — Nonspecific low blood-pressure reading (blood pressure, low reading), R06.9 — Unspecified abnormalities of breathing (breathing), R09.3 — Abnormal sputum (sputum), R09.89 — Other specified symptoms and signs involving the circulatory and respiratory systems (chest sounds), R25.0 — Abnormal head movements (head movement), R25.1 — Tremor, unspecified (movement, involuntary, tremor), R25.2 — Cramp and spasm (movement, involuntary, spasm), R25.3 — Fasciculation (movement, involuntary, fasciculation), R25.8 — Other abnormal involuntary movements (movement, involuntary, specified type NEC), R25.9 — Unspecified abnormal involuntary movements (movement, involuntary), R29.2 — Abnormal reflex (knee jerk), R29.3 — Abnormal posture (posture), R29.890 — Loss of height (loss of, height), R39.198 — Other difficulties with micturition (urination NEC), +242 more

Contextual Map

Every relationship of R19.12 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.

Hierarchy

• R00-R99 — Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) (R00-R99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R10-R19 — Symptoms and signs involving the digestive system and abdomen[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Clinical classification (CCSR)

• SYM006 — Abdominal pain and other digestive/abdomen signs and symptoms[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 391 — ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC[MS-DRG]: “ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC (MDC 06)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 392 — ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC[MS-DRG]: “ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC (MDC 06)”— 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

Index entries

• Abnormal, abnormality, abnormalities, bowel sounds, hyperactive[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Hyperactive, hyperactivity, bowel sounds[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (29)

• R19 — Other symptoms and signs involving the digestive system and abdomen[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.0 — Intra-abdominal and pelvic swelling, mass and lump[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.00 — Intra-abdominal and pelvic swelling, mass and lump, unspecified site[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.01 — Right upper quadrant abdominal swelling, mass and lump[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.02 — Left upper quadrant abdominal swelling, mass and lump[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.03 — Right lower quadrant abdominal swelling, mass and lump[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.04 — Left lower quadrant abdominal swelling, mass and lump[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R19.05 — Periumbilic swelling, mass or lump[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 21 more

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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R19.12 in its code family, with their registry titles.

• R19.06 — Epigastric swelling, mass or lump
• R19.07 — Generalized intra-abdominal and pelvic swelling, mass and lump
• R19.09 — Other intra-abdominal and pelvic swelling, mass and lump
• R19.1 — Abnormal bowel sounds
• R19.11 — Absent bowel sounds
• R19.15 — Other abnormal bowel sounds
• R19.2 — Visible peristalsis
• R19.3 — Abdominal rigidity
• R19.30 — Abdominal rigidity, unspecified site
• R19.31 — Right upper quadrant abdominal rigidity

View all codes in the R19 family