ICD-10 Coding for Cyclical Vomiting Syndrome(R11.15, G43.A0)
Complete ICD-10-CM coding and documentation guide for Cyclical Vomiting Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cyclical Vomiting Syndrome
R11.15Primary Range
Cyclical vomiting syndrome unrelated to migraine
Primary code for CVS when there is no migraine association.
Cyclical vomiting syndrome related to migraine
Used when CVS is associated with migraine.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R11.15 | Cyclical vomiting syndrome unrelated to migraine | Use when CVS episodes are not associated with migraine symptoms. |
|
| G43.A0 | Cyclical vomiting syndrome with migraine, not intractable | Use when CVS episodes are associated with migraine symptoms. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for cyclical vomiting
Essential facts and insights about Cyclical Vomiting Syndrome
Primary ICD-10-CM Codes for cyclical vomiting
Decision Criteria
clinical Criteria
- No migraine symptoms or family history
Applicable To
- Cyclical vomiting without migraine
Clinical Validation Requirements
- Documentation must state 'unrelated to migraine'
- Negative family history of migraines
Code-Specific Risks
- Misclassification if migraine is not ruled out
Coding Notes
- Ensure clear documentation of migraine association status.
G43.A0 - Cyclical vomiting syndrome with migraine, not intractable
Use when CVS episodes are associated with migraine symptoms.
Applicable To
- Cyclical vomiting with migraine
Excludes
- Cyclical vomiting without migraine (R11.15)
Clinical Validation Requirements
- Documentation must state 'associated with migraine'
- Family history of migraines
Coding Notes
Ensure migraine association is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dehydration
E86.0Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cyclical Vomiting Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R11.15.
Impact
Clinical: Inadequate clinical management., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use structured templates for episode documentation., Ensure all differential diagnoses are ruled out.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data recording.
Mitigation Strategy
Query provider to confirm if episodes meet Rome IV criteria for CVS.
Impact
Lack of documentation on migraine association can lead to audit issues.
Mitigation Strategy
Implement mandatory documentation fields for migraine history.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Cyclical Vomiting Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cyclical Vomiting Syndrome
Use these documentation templates to ensure complete and accurate documentation for Cyclical Vomiting Syndrome. These templates include all required elements for proper coding and billing.
CVS Episode Documentation
Specialty: NeurologyRequired Elements
- Episode frequency
- Migraine history
- Exclusion of other causes
- Treatment response
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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