Gastrointestinal Bleeding ICD-10-CM codes

K92.2 is gastrointestinal hemorrhage unspecified and covers gastric or intestinal bleeding NOS and hematochezia. K92.0 is hematemesis and K92.1 is melena. These codes are for bleeding whose source has not been identified; once the provider documents the lesion, the combination code for that lesion replaces the K92 code. Rectal bleeding without a source is K62.5, which K92.2 excludes.

Combination codes exist for most bleeding sources: peptic ulcers with hemorrhage (K25.0, K25.4, K26.0, K26.4 and the parallel K27 and K28 codes), gastritis or duodenitis with bleeding (K29.01, K29.71 and the other K29 codes ending in 1), angiodysplasia of the stomach (K31.811) or colon (K55.21) with hemorrhage, diverticular bleeding (K57.31 and similar), esophageal ulcer with bleeding (K22.11), Mallory-Weiss tear (K22.6), and bleeding esophageal varices (I85.01 or I85.11). K92.2 has an Excludes1 note for each of these.

Under the guideline for the word with, a GI bleed documented alongside a condition whose index entry has a with-bleeding subterm (gastritis, gastric or duodenal ulcer, diverticulosis, angiodysplasia) is presumed related and reported with the combination code, unless the provider states the bleeding comes from a different source. When endoscopy finds a lesion but the provider says it is not the bleeding source, keep K92.2 and code the lesion without bleeding.

Acute blood loss anemia (D62) is coded in addition when documented. For a patient on anticoagulants, add Z79.01, and if the provider attributes the bleed to the anticoagulant taken as prescribed, add T45.515A for the adverse effect with the bleed sequenced first.