Symptoms and signs involving the digestive system and abdomen
ICD-10 Codes (68)
R11R11.0R11.1R11.10R11.11R11.12R11.13R11.14R11.15R11.2R12R13R13.0R13.1R13.10R13.11R13.12R13.13R13.14R13.19R14R14.0R14.1R14.2R14.3R15R15.0R15.1R15.2R15.9R16R16.0R16.1R16.2R17R18R18.0R18.8R19R19.0R19.00R19.01R19.02R19.03R19.04R19.05R19.06R19.07R19.09R19.1R19.11R19.12R19.15R19.2R19.3R19.30R19.31R19.32R19.33R19.34R19.35R19.36R19.37R19.4R19.5R19.6R19.7R19.8Updates & Changes
FY 2026 Updates
Deleted Codes
No codes deleted in this range for FY 2026
No significant changes for FY 2026
This range maintains stability with current coding practices
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for R10-R19 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
The ICD-10 code range R10-R19 pertains to symptoms and signs involving the digestive system and abdomen. These codes are used to document various symptoms and clinical signs that are indicative of conditions affecting the digestive system, including but not limited to abdominal pain, nausea, vomiting, diarrhea, and constipation. They are not used to code definitive diagnoses but rather to capture symptoms that may lead to a definitive diagnosis.
Key Usage Points:
- •R10-R19 codes are used when a definitive diagnosis has not been established.
- •These codes are used for symptoms related to the digestive system and abdomen.
- •R10 codes are specifically for abdominal and pelvic pain.
- •R11 codes are used for symptoms related to nausea and vomiting.
- •R12-R19 codes cover other symptoms and signs involving the digestive system.
Coding Guidelines
When to Use:
- ✓When a patient presents with abdominal pain without a known cause.
- ✓When a patient has symptoms of nausea and vomiting, but the cause is not yet determined.
- ✓For patients with digestive symptoms like diarrhea or constipation without a definitive diagnosis.
- ✓When a patient has abnormal findings on diagnostic imaging of the digestive system without a known cause.
When NOT to Use:
- ✗When a definitive diagnosis has been established.
- ✗When the symptoms are not related to the digestive system or abdomen.
- ✗When the symptoms are a known side effect of a medication.
- ✗When the symptoms are due to a condition that has its own specific code.
Code Exclusions
Always verify exclusions using the ICD-10-CM Official Guidelines for Coding and Reporting.
Documentation Requirements
Documentation for R10-R19 codes should clearly describe the patient's symptoms and their relation to the digestive system or abdomen. The documentation should also include any relevant history, examination findings, and diagnostic test results.
Clinical Information:
- •Detailed description of the patient's symptoms.
- •Location of the symptoms (if applicable).
- •Duration and frequency of the symptoms.
- •Any factors that exacerbate or alleviate the symptoms.
- •Results of any relevant diagnostic tests.
Supporting Evidence:
- •Patient's medical history.
- •Physical examination findings.
- •Diagnostic imaging reports.
- •Laboratory test results.
Good Documentation Example:
Patient presents with severe, intermittent abdominal pain in the lower right quadrant for the past two days. Pain is exacerbated by movement and alleviated by rest. No nausea, vomiting, or changes in bowel movements. Abdominal examination reveals tenderness in the lower right quadrant. CT scan ordered.
Poor Documentation Example:
Patient has stomach pain.
Common Documentation Errors:
- âš Not providing enough detail about the patient's symptoms.
- âš Not specifying the location of the symptoms.
- âš Not documenting the duration and frequency of the symptoms.
- âš Not including relevant examination findings or test results.
Range Statistics
Coding Complexity
Coding for R10-R19 requires a solid understanding of the digestive system and the ability to interpret clinical information. The complexity is increased by the need to differentiate between symptoms and definitive diagnoses, and to apply the correct code based on the patient's symptoms.
Key Factors:
- â–¸Determining the correct code based on the patient's symptoms.
- â–¸Identifying any underlying conditions that may be causing the symptoms.
- â–¸Understanding the relationship between the symptoms and the digestive system.
- â–¸Interpreting the results of diagnostic tests.
- â–¸Applying the ICD-10-CM Official Guidelines for Coding and Reporting.
Specialty Focus
R10-R19 codes are commonly used in primary care, emergency medicine, and gastroenterology. They are used to document symptoms before a definitive diagnosis is made.
Primary Specialties:
Clinical Scenarios:
- • A patient presents to the ER with severe abdominal pain.
- • A patient reports chronic constipation during a routine primary care visit.
- • A patient undergoes a gastroenterology consultation for recurrent nausea and vomiting.
Resources & References
Resources for R10-R19 codes include the ICD-10-CM Official Guidelines for Coding and Reporting, clinical reference books, and educational materials from professional coding organizations.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Health Information Management Association (AHIMA) Coding Guidelines
- American Academy of Professional Coders (AAPC) Coding Guidelines
Clinical References:
- Clinical Coding Workout
- ICD-10-CM Expert for Hospitals
Educational Materials:
- AHIMA ICD-10-CM Training
- AAPC ICD-10-CM Training
Frequently Asked Questions
Can R10-R19 codes be used for definitive diagnoses?
No, R10-R19 codes are used to document symptoms related to the digestive system and abdomen, not definitive diagnoses.