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

ICD-10 R19.4

Billable / Specific

Change in bowel habit

R19
Block
0
Synonyms
217
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM R19.4

ICD-10-CM code R19.4 represents Change in bowel habit. This is a billable/specific code in the Symptoms, Signs, and Abnormal Findings chapter (block R19). The 2026 edition of ICD-10-CM R19.4 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with R19.4. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • constipation (K59.0-)
  • functional diarrhea (K59.1)

Medicare LCD Coverage for R19.4

Local Coverage Determinations (LCDs) from CMS MACs that list R19.4 as a covered diagnosis.

217 LCDs

Showing top 10 of 217 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45398 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44392 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45386 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45378 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44390 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45393 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44394 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44401 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 44407 →
CMS LCD: Billing and Coding: Diagnostic Colonoscopy
Article ID: 55937, Effective: 2026-02-04 00:00:00, 244 covered, 1 non-covered
CPT 45391 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing R19.4.

7 policies

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

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: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56456
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632
Billing and Coding: Diagnostic and Therapeutic Colonoscopy
Policy ID: ART-57342

CPT Codes Commonly Billed with R19.4

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

No procedure linkages on file for R19.4

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 R19.4 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
R19.4 78799 10000

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

ICD-10 R19.4, Billing FAQ

Is ICD-10 code R19.4 billable? +

Yes, R19.4 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 R19.4? +

Type 1 Excludes (never code together with R19.4): constipation (K59.0-); functional diarrhea (K59.1)

What ICD-9 codes does R19.4 map to? +

Per CMS GEMs, R19.4 maps to ICD-9 codes: 78799. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

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

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