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ICD-10 Guide
ICD-10 CodesK31.84

K31.84

Billable

Gastroparesis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K31.84 is a billable code used to indicate a diagnosis of gastroparesis.

Key Diagnostic Point:

Gastroparesis is a condition characterized by delayed gastric emptying in the absence of any mechanical obstruction. Clinically, patients may present with symptoms such as nausea, vomiting, early satiety, bloating, and abdominal pain. The anatomy involved primarily includes the stomach and the pyloric sphincter, which regulates the passage of food into the small intestine. Disease progression can vary; some patients may experience intermittent symptoms, while others may have chronic issues that significantly impact their quality of life. Diagnostic considerations for gastroparesis typically involve gastric emptying studies, which measure the time it takes for food to leave the stomach. Other assessments may include upper gastrointestinal (GI) endoscopy to rule out obstructions and imaging studies to evaluate gastric motility. The condition can be secondary to various underlying issues, including diabetes mellitus, neurological disorders, and post-surgical complications, making a thorough clinical evaluation essential for accurate diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires specialized tests for confirmation.
  • Treatment complexity: Management may involve dietary changes, medications, and in severe cases, surgical interventions.
  • Documentation requirements: Detailed clinical notes are necessary to justify the diagnosis and treatment plan.
  • Coding specificity: Requires accurate coding to reflect the specific type and cause of gastroparesis.

Audit Risk Factors

  • Common coding errors: Misclassification of gastroparesis as a mechanical obstruction.
  • Documentation gaps: Insufficient clinical details regarding symptomatology and diagnostic testing.
  • Billing challenges: Potential denials due to lack of clear evidence supporting the diagnosis.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Endocrinology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Gastroparesis significantly affects patient quality of life and can lead to malnutrition and dehydration if not managed properly. It is prevalent among individuals with diabetes and can contribute to increased healthcare utilization, including frequent hospitalizations. Understanding the epidemiology of gastroparesis is crucial for developing effective management strategies and quality measures aimed at improving patient outcomes.

ICD-9 vs ICD-10

Gastroparesis significantly affects patient quality of life and can lead to malnutrition and dehydration if not managed properly. It is prevalent among individuals with diabetes and can contribute to increased healthcare utilization, including frequent hospitalizations. Understanding the epidemiology of gastroparesis is crucial for developing effective management strategies and quality measures aimed at improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for prior authorization for certain diagnostic tests and treatments. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all clinical notes clearly support the diagnosis of gastroparesis and any associated conditions to avoid billing challenges. Best practices include maintaining thorough records of patient interactions and treatment plans.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K31.84?

K31.84 specifically covers gastroparesis not due to any mechanical obstruction. This includes idiopathic gastroparesis and cases secondary to conditions such as diabetes, neurological disorders, or post-surgical complications.

When should K31.84 be used instead of related codes?

K31.84 should be used when the gastroparesis is not attributable to a mechanical obstruction. If the condition is secondary to diabetes or another specific cause, the corresponding code should be selected.

What documentation supports K31.84?

Documentation should include a detailed history of symptoms, results from gastric emptying studies, and any relevant imaging or endoscopic findings that rule out mechanical causes.