ICD-10 Coding for Upper Gastric Pain(R10.13, K29.70)
Complete ICD-10-CM coding and documentation guide for Upper Gastric Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Upper Gastric Pain
R10-R19Primary Range
Symptoms and signs involving the digestive system and abdomen
This range includes codes for abdominal pain, including epigastric pain.
Diseases of esophagus, stomach, and duodenum
This range includes definitive diagnoses that may present with epigastric pain, such as gastritis and GERD.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R10.13 | Epigastric pain | Use when the patient presents with pain localized to the epigastric region without a confirmed diagnosis. |
|
| K29.70 | Gastritis, unspecified, without bleeding | Use when gastritis is confirmed via endoscopy. |
|
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 upper gastric pain
Essential facts and insights about Upper Gastric Pain
Primary ICD-10-CM Codes for upper gastric pain
Decision Criteria
clinical Criteria
- Pain localized to the epigastric region
coding Criteria
- No definitive diagnosis available
Applicable To
- Pain in the epigastric region
Excludes
- Acute abdomen (R10.0)
Clinical Validation Requirements
- Pain localization to the epigastric region
- Relation to meals
- Palpation findings
Code-Specific Risks
- Confusion with other abdominal pain codes
- Incorrect use when a definitive diagnosis is available
Coding Notes
- Ensure documentation specifies the epigastric region to avoid miscoding.
K29.70 - Gastritis, unspecified, without bleeding
Use when gastritis is confirmed via endoscopy.
Applicable To
- Unspecified gastritis without bleeding
Excludes
- Gastritis with bleeding (K29.71)
Clinical Validation Requirements
- Endoscopic confirmation of gastritis
- H. pylori test results
Coding Notes
Replace R10.13 with K29.70 when gastritis is confirmed.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Epigastric tenderness
R10.816Differential 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 Upper Gastric Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.13.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Use anatomical landmarks in documentation, Clarify pain characteristics with patient
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Replace R10.13 with the specific diagnosis code once confirmed.
Impact
Inadequate documentation of pain location can lead to coding errors.
Mitigation Strategy
Implement standardized pain assessment protocols.
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 Upper Gastric Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Upper Gastric Pain
Use these documentation templates to ensure complete and accurate documentation for Upper Gastric Pain. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Epigastric Pain
Specialty: Emergency MedicineRequired Elements
- Pain location
- Pain quality
- Associated symptoms
- Palpation findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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