Right upper quadrant rebound abdominal tenderness
ICD-10 R10.821 is a billable code used to indicate a diagnosis of right upper quadrant rebound abdominal tenderness.
Right upper quadrant rebound abdominal tenderness is a clinical sign indicative of peritoneal irritation, often associated with acute abdominal conditions. This symptom is characterized by pain that worsens upon release of pressure from the abdomen, suggesting underlying inflammation or irritation of the peritoneum. Common causes include appendicitis, cholecystitis, pancreatitis, and perforated viscus. The presence of rebound tenderness is typically assessed during a physical examination, where the clinician applies pressure to the abdomen and then quickly releases it. The sudden release can cause a sharp pain in the right upper quadrant, indicating potential serious conditions that may require immediate medical intervention. Laboratory findings may include elevated white blood cell counts, indicating infection or inflammation, and imaging studies such as ultrasound or CT scans may be utilized to identify the underlying cause. Accurate identification and documentation of rebound tenderness are crucial for appropriate diagnosis and treatment planning.
Detailed notes on physical examination findings, including location and nature of tenderness.
Patients presenting with abdominal pain, nausea, and vomiting.
Ensure that the clinical context supports the diagnosis of rebound tenderness.
Acute care notes must include time of onset, severity, and associated symptoms.
Patients with acute abdominal pain requiring immediate evaluation.
Rapid assessment and documentation are critical due to the potential for surgical intervention.
Used when a patient presents with rebound tenderness and requires further evaluation.
Document the reason for the visit, examination findings, and any diagnostic tests performed.
Emergency medicine documentation must be timely and thorough due to the acute nature of presentations.
Rebound tenderness is a clinical sign indicating peritoneal irritation, where pain is felt upon the release of pressure from the abdomen.
It is assessed during a physical examination by applying pressure to the abdomen and observing for increased pain upon release.
