Heme postive stool vs melena

Hello. I am a coder for the ASC. One of our patient's had a EGD with indication of Occult Stool 792.1. After the procedure there was no findings, so I coded with the indication 792.1. However, the physician's office use 578.1. I questioned that and their office stated that it was the same blood in stools. I coded what was the indication provided to me on the operative report. Please advise, what would be the correct dx code. Thanks, please have a wonderful day.


reetown3

re: HEME POSTIVE STOOL VS MELENA

They are not the same at all. I found this information on www.merckmanuals.com, I hope this helps


Melena is black, tarry stool and typically indicates upper GI bleeding, but bleeding from a source in the small bowel or right colon may also be the cause. About 100 to 200 mL of blood in the upper GI tract is required to cause melena, which may persist for several days after bleeding has ceased. Black stool that does not contain occult blood may result from ingestion of iron, bismuth, or various foods and should not be mistaken for melena.


Chronic occult bleeding can occur from anywhere in the GI tract and is detectable by chemical testing of a stool specimen

re: HEME POSTIVE STOOL VS MELENA

Thanks for your help. Information was very helpful, which means our facility code is correct. Please have a good day.