ICD-10 Coding for Right Lower Quadrant Abdominal Pain(R10.31, K35.9)
Complete ICD-10-CM coding and documentation guide for Right Lower Quadrant Abdominal Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Lower Quadrant Abdominal Pain
R10.0-R10.9Primary Range
Codes for abdominal and pelvic pain
This range includes codes for various types of abdominal pain, including RLQ pain.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R10.31 | Right lower quadrant pain | Use when RLQ pain is the primary complaint without a confirmed diagnosis. |
|
| K35.9 | Acute appendicitis, unspecified | Use when appendicitis is confirmed by imaging or surgery. |
|
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 RLQ abdominal pain
Essential facts and insights about Right Lower Quadrant Abdominal Pain
Primary ICD-10-CM Codes for rlq abd pain
Decision Criteria
clinical Criteria
- RLQ pain without confirmed etiology
coding Criteria
- No definitive diagnosis like appendicitis
Applicable To
- Pain in right iliac fossa
Excludes
- Appendicitis (K35-K37)
Clinical Validation Requirements
- Documented RLQ pain without definitive diagnosis
- No imaging or lab results confirming specific etiology
Code-Specific Risks
- Using R10.31 when a definitive diagnosis like appendicitis is confirmed.
Coding Notes
- Ensure documentation specifies RLQ location and any associated symptoms.
K35.9 - Acute appendicitis, unspecified
Use when appendicitis is confirmed by imaging or surgery.
Applicable To
- Appendicitis confirmed by imaging
Excludes
- RLQ pain without confirmed appendicitis (R10.31)
Clinical Validation Requirements
- CT or surgical confirmation of appendicitis
Coding Notes
Ensure appendicitis is confirmed before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Rebound tenderness
R10.813Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Lower Quadrant Abdominal Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.31.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Potential for coding audits and penalties., Financial: Incorrect DRG assignment affecting reimbursement.
Mitigation Strategy
Train staff on documentation specificity, Use templates for consistent documentation
Impact
Reimbursement: Incorrect DRG assignment may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Switch to K35.9 once appendicitis is confirmed by imaging or surgery.
Impact
Incorrect use of R10.31 when appendicitis is confirmed.
Mitigation Strategy
Verify imaging results before final code assignment.
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 Right Lower Quadrant Abdominal Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Lower Quadrant Abdominal Pain
Use these documentation templates to ensure complete and accurate documentation for Right Lower Quadrant Abdominal Pain. These templates include all required elements for proper coding and billing.
RLQ Pain Evaluation
Specialty: Emergency MedicineRequired Elements
- Pain location and quality
- Associated symptoms
- Physical exam findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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