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v1.0.0
ICD-10 Guide
ICD-10 CodesR19.7

R19.7

Diarrhea, unspecified

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

Code Description

ICD-10 R19.7 is a billable code used to indicate a diagnosis of diarrhea, unspecified.

Key Diagnostic Point:

Diarrhea, unspecified (ICD-10 code R19.7) refers to the condition characterized by an increase in the frequency and fluidity of bowel movements without a specified cause. This symptom can arise from various underlying conditions, including infections, inflammatory bowel disease, malabsorption syndromes, and dietary factors. Patients may present with acute or chronic diarrhea, which can lead to dehydration and electrolyte imbalances if not managed appropriately. The unspecified nature of this code indicates that further investigation is needed to determine the underlying etiology. Clinicians should assess the patient's history, conduct a physical examination, and consider laboratory tests such as stool analysis, blood tests, and imaging studies to identify the cause of diarrhea. Accurate documentation of the patient's symptoms, duration, and associated factors is crucial for effective coding and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes requiring thorough investigation.
  • Need for detailed patient history and symptom description.
  • Differentiation from other gastrointestinal disorders.
  • Potential for misclassification if additional symptoms are present.

Audit Risk Factors

  • Inadequate documentation supporting the unspecified diagnosis.
  • Failure to explore and document potential underlying causes.
  • Misuse of R19.7 when a more specific diagnosis is available.
  • Inconsistent coding practices across different providers.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Comprehensive patient history, including duration and characteristics of diarrhea, associated symptoms, and any recent travel or dietary changes.

Common Clinical Scenarios

Patients presenting with acute diarrhea following a recent gastrointestinal infection or chronic diarrhea due to underlying conditions like IBS.

Billing Considerations

Ensure that all relevant tests and evaluations are documented to support the diagnosis and any potential underlying conditions.

Emergency Medicine

Documentation Requirements

Detailed acute care documentation, including vital signs, hydration status, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with severe dehydration due to acute diarrhea, requiring immediate treatment.

Billing Considerations

Rapid assessment and documentation of the patient's condition are critical for coding and billing purposes.

Coding Guidelines

Inclusion Criteria

Use R19.7 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the cause of diarrhea is not specified
  • Document all relevant clinical findings and assessments

Exclusion Criteria

Do NOT use R19.7 When
No specific exclusions found.

Related CPT Codes

87430CPT Code

Infectious agent detection by nucleic acid (DNA or RNA); enteric pathogens

Clinical Scenario

Used when stool tests are performed to identify infectious causes of diarrhea.

Documentation Requirements

Document the rationale for testing and any clinical findings that support the need for testing.

Specialty Considerations

Ensure that the testing aligns with the clinical presentation and suspected diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has increased the specificity of coding, but R19.7 remains a common code for unspecified diarrhea. Coders must ensure that documentation supports the use of this code to avoid denials and audits.

ICD-9 vs ICD-10

The transition to ICD-10 has increased the specificity of coding, but R19.7 remains a common code for unspecified diarrhea. Coders must ensure that documentation supports the use of this code to avoid denials and audits.

Reimbursement & Billing Impact

The transition to ICD-10 has increased the specificity of coding, but R19.7 remains a common code for unspecified diarrhea. Coders must ensure that documentation supports the use of this code to avoid denials and audits.

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

When should R19.7 be used?

R19.7 should be used when the cause of diarrhea is not specified and further investigation is needed. It is important to document all relevant clinical findings to support the use of this code.