ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 K62.5

Billable / Specific CC

Hemorrhage of anus and rectum

K62
Block
0
Synonyms
228
LCDs
9
Payer Policies
0
Linked CPTs

About ICD-10-CM K62.5

ICD-10-CM code K62.5 represents Hemorrhage of anus and rectum. This is a billable/specific code in the Digestive System chapter (block K62). The 2026 edition of ICD-10-CM K62.5 became effective on October 1, 2025.

Coding Tips for K62.5

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

K62.5 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Type 1 Excludes

Pure excludes, these codes can never be coded together with K62.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • gastrointestinal bleeding NOS (K92.2)
  • melena (K92.1)
  • neonatal rectal hemorrhage (P54.2)

Inpatient DRG Impact, CC

codes Hemorrhage of anus and rectum. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for K62.5

Local Coverage Determinations (LCDs) from CMS MACs that list K62.5 as a covered diagnosis.

228 LCDs

Showing top 10 of 228 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76872 →
CMS LCD: Billing and Coding: Transrectal Ultrasound
Article ID: 57427, Effective: 2024-10-01 00:00:00, 118 covered, 0 non-covered
CPT 76873 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K62.5.

9 policies

5 Medicare

Billing and Coding: Diagnostic Colonoscopy
Policy ID: ART-55937
Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Policy ID: ART-56394
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632

1 Aetna

Colonoscopy, Colorectal Cancer Screening, and Related Procedures
Policy ID: CPB-0516

CPT Codes Commonly Billed with K62.5

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for K62.5

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert K62.5 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
K62.5 5693 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 K62.5, Billing FAQ

Is ICD-10 code K62.5 billable? +

Yes, K62.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for K62.5? +

Type 1 Excludes (never code together with K62.5): gastrointestinal bleeding NOS (K92.2); melena (K92.1); neonatal rectal hemorrhage (P54.2)

Is K62.5 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does K62.5 map to? +

Per CMS GEMs, K62.5 maps to ICD-9 codes: 5693. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Faster Approvals

Ready to Cut Your Enrollment Timeline in Half?

Join providers in all 50 states who handed off credentialing to a dedicated specialist. Create your free account in minutes and start enrolling the same day.

All 50 States Covered
No Long-Term Contracts
HIPAA HIPAA Compliant Platform
Dedicated Specialist Included