R19.4
BillableChange in bowel habit
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is R19.4 an HCC code?
No. R19.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R19.4 is the ICD-10-CM diagnosis code for change in bowel habit. A noticeable change in a person's normal bowel movement patterns, such as increased frequency, decreased frequency, or changes in consistency. R19.4 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering symptoms and signs involving the digestive system and abdomen (r10-r19).
R19.4 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the specific nature of the change (constipation, diarrhea, alternating patterns) and duration to guide further workup.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R19.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific nature of the change (constipation, diarrhea, alternating patterns) and duration to guide further workup
- •Investigate for underlying causes such as dietary changes, medications, or gastrointestinal disorders