ICD Code K92.1

ICD code K92.1 is a classification used to identify the presence of melena, which refers to black, tarry stools that typically indicate bleeding in the upper gastrointestinal tract. This code is utilized by healthcare providers to document and communicate this specific condition for billing, treatment, and statistical purposes within the healthcare system.

1. Presence of Black, Tarry Stools: The patient presents with stools that are black and tarry in appearance, indicating the presence of digested blood.

2. Upper Gastrointestinal Bleeding: There is evidence or suspicion of bleeding originating from the upper gastrointestinal tract, such as the esophagus, stomach, or duodenum.

3. Positive Fecal Occult Blood Test: Laboratory tests confirm the presence of blood in the stool that is not visible to the naked eye.

4. History of Peptic Ulcer Disease: The patient has a known history of peptic ulcers, which could contribute to gastrointestinal bleeding.

5. Use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): The patient has a history of using NSAIDs, which can increase the risk of gastrointestinal bleeding.

6. Symptoms of Anemia: The patient exhibits symptoms such as fatigue, pallor, or shortness of breath, which may indicate anemia due to blood loss.

7. Endoscopic Findings: Endoscopy reveals lesions, ulcers, or other abnormalities in the upper gastrointestinal tract that could be the source of bleeding.

8. Hemodynamic Instability: The patient shows signs of hemodynamic instability, such as low blood pressure or tachycardia, potentially due to significant blood loss.

9. Recent Gastrointestinal Surgery or Trauma: The patient has undergone recent surgery or experienced trauma that could lead to gastrointestinal bleeding.

10. Exclusion of Lower Gastrointestinal Sources: Other potential sources of bleeding from the lower gastrointestinal tract have been ruled out through diagnostic testing.

For the ICD code K92.1, which pertains to melena, the relevant CPT codes that may be applicable for treatment or diagnostic procedures include:

1. CPT 45378 - Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure).

2. CPT 43235 - Esophagogastroduodenoscopy (EGD), flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure).

3. CPT 74230 - Radiologic examination, gastrointestinal tract, upper; with or without KUB.

4. CPT 82270 - Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, 1-3 simultaneous determinations.

5. CPT 82272 - Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, single determination for colorectal neoplasm screening (e.g., patient was provided three cards or single triple card for consecutive collection).

These CPT codes are commonly associated with the diagnostic and procedural approaches to address the symptoms or underlying causes related to the ICD code K92.1. Always ensure to verify the most current coding guidelines and payer-specific requirements when billing for these services.

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