Melena

This code represents the passage of dark, tarry stools resulting from upper gastrointestinal bleeding. The characteristic black color is due to the digestion of blood by intestinal enzymes. Melena indicates bleeding proximal to the ligament of Treitz, often from conditions like peptic ulcers, gastritis, or esophageal varices.

Use this code when documentation explicitly states "melena" or describes dark, tarry stools consistent with digested blood. This typically occurs in patients presenting with acute or chronic GI bleeding symptoms. Supporting documentation should include physician notes detailing the stool characteristics and clinical assessment.

• Do not code with R19.5 (occult blood in feces) as per Excludes1 note; these conditions are mutually exclusive.
• Always look for the underlying cause of the melena and code it as the primary diagnosis if known and treated.
• Ensure the documentation clearly distinguishes melena from other forms of GI bleeding, such as hematochezia.