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v1.0.0
ICD-10 Guide
ICD-10 CodesR19.35

R19.35

Periumbilic abdominal rigidity

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R19.35 is a billable code used to indicate a diagnosis of periumbilic abdominal rigidity.

Key Diagnostic Point:

Periumbilic abdominal rigidity refers to a clinical finding characterized by increased tension and firmness in the abdominal wall around the umbilicus (navel). This rigidity can be a sign of underlying pathology, often indicating irritation or inflammation of the peritoneum, which may occur due to various conditions such as appendicitis, diverticulitis, or peritonitis. Patients may present with accompanying symptoms such as abdominal pain, tenderness, and changes in bowel habits. The rigidity is typically assessed during a physical examination, where the clinician palpates the abdomen to evaluate for signs of guarding or rigidity. This finding is significant as it may suggest an acute abdomen requiring further diagnostic evaluation, including imaging studies or laboratory tests to identify the underlying cause. Proper documentation of the presence of periumbilic abdominal rigidity is crucial for accurate coding and to guide clinical management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and underlying causes
  • Need for thorough documentation of physical examination findings
  • Differentiation from other abdominal rigidity codes
  • Potential overlap with other abdominal symptoms

Audit Risk Factors

  • Inadequate documentation of physical examination findings
  • Failure to link the symptom to a definitive diagnosis
  • Misinterpretation of abdominal rigidity as a standalone diagnosis
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed notes on abdominal examination findings, including location and severity of rigidity.

Common Clinical Scenarios

Patients presenting with abdominal pain and rigidity during routine evaluations or follow-ups.

Billing Considerations

Ensure that the clinical context is well documented to support the diagnosis and any associated conditions.

Emergency Medicine

Documentation Requirements

Acute care documentation must include time of onset, associated symptoms, and immediate interventions.

Common Clinical Scenarios

Patients with acute abdominal pain presenting to the emergency department with signs of rigidity.

Billing Considerations

Rapid assessment and documentation are critical due to the potential for surgical intervention.

Coding Guidelines

Inclusion Criteria

Use R19.35 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the symptom is documented clearly and linked to any relevant diagnoses
  • Use additional codes to capture associated conditions or complications as necessary

Exclusion Criteria

Do NOT use R19.35 When
No specific exclusions found.

Related CPT Codes

99283CPT Code

Emergency department visit, level 3

Clinical Scenario

Used when a patient presents with abdominal rigidity and requires moderate complexity medical decision-making.

Documentation Requirements

Document the history, examination findings, and medical decision-making process.

Specialty Considerations

Emergency medicine providers should ensure thorough documentation to support the level of service.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of symptoms like periumbilic abdominal rigidity, improving the granularity of data for clinical analysis and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of symptoms like periumbilic abdominal rigidity, improving the granularity of data for clinical analysis and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the significance of periumbilic abdominal rigidity?

Periumbilic abdominal rigidity is a clinical sign that may indicate serious underlying conditions such as appendicitis or peritonitis. It requires careful evaluation and documentation to guide appropriate management.