ICD-10 Coding for Stomach Pain(R10.0, R10.31)
Complete ICD-10-CM coding and documentation guide for Stomach Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stomach Pain
R10.0-R10.9Primary Range
Codes for abdominal and pelvic pain
This range includes codes for various types of abdominal pain, categorized by location and severity.
Codes for appendicitis
These codes are used when appendicitis is confirmed as the cause of abdominal 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 |
|---|---|---|---|
| R10.0 | Acute abdomen | Use when the patient presents with severe, sudden-onset abdominal pain requiring urgent evaluation. |
|
| R10.31 | Right lower quadrant pain | Use when the patient presents with localized pain in the right lower quadrant. |
|
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 stomach pain
Essential facts and insights about Stomach Pain
Primary ICD-10-CM Codes for stomach pain
Decision Criteria
clinical Criteria
- Presence of guarding or rigidity
Applicable To
- Severe, sudden-onset abdominal pain
Excludes
- Chronic abdominal pain
Clinical Validation Requirements
- CT showing free air/perforation
- WBC >12,000 + rigid abdomen
Code-Specific Risks
- Misclassification if not acute
- Overuse in non-urgent cases
Coding Notes
- Ensure documentation specifies 'acute' to differentiate from chronic conditions.
R10.31 - Right lower quadrant pain
Use when the patient presents with localized pain in the right lower quadrant.
Applicable To
- Localized RLQ pain
Excludes
- Generalized abdominal pain
Clinical Validation Requirements
- Ultrasound/CT confirming appendiceal inflammation
Coding Notes
Ensure documentation specifies the quadrant and any associated symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Acute appendicitis with perforation
K35.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Stomach Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Include a checklist for associated symptoms in documentation templates., Regular training on documentation standards.
Impact
Reimbursement: May lead to lower DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces the accuracy of clinical data.
Mitigation Strategy
Always document the specific location and severity of pain.
Impact
Risk of audits due to frequent use of unspecified codes.
Mitigation Strategy
Implement regular coding audits and training sessions.
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 Stomach Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stomach Pain
Use these documentation templates to ensure complete and accurate documentation for Stomach Pain. These templates include all required elements for proper coding and billing.
Emergency Department Evaluation
Specialty: Emergency MedicineRequired Elements
- Location of pain
- Severity on a scale of 0-10
- Quality of pain
- Associated symptoms
- Clinical findings
- Diagnostic evidence
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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