Epigastric pain
ICD-10 R10.13 is a billable code used to indicate a diagnosis of epigastric pain.
Epigastric pain refers to discomfort or pain localized in the upper central region of the abdomen, just below the ribcage. This symptom can arise from various underlying conditions affecting the gastrointestinal tract, such as gastritis, peptic ulcers, or gastroesophageal reflux disease (GERD). It may also be associated with non-gastrointestinal issues, including cardiac conditions or pancreatitis. Patients may describe the pain as sharp, dull, burning, or cramping, and it can be intermittent or constant. Associated symptoms may include nausea, vomiting, bloating, and changes in appetite. Clinical evaluation often involves a thorough history and physical examination, with laboratory tests and imaging studies as needed to identify the underlying cause. Accurate coding of epigastric pain requires careful documentation of the symptom's characteristics, duration, and any associated findings to ensure appropriate diagnosis and treatment.
Detailed history of present illness, including onset, duration, and associated symptoms.
Patients presenting with chronic epigastric pain, often requiring diagnostic testing to rule out conditions like ulcers or GERD.
Consideration of comorbidities that may contribute to epigastric pain, such as diabetes or cardiovascular disease.
Acute assessment including vital signs, pain scale, and immediate lab results.
Patients presenting with acute epigastric pain, potentially indicating serious conditions like pancreatitis or myocardial infarction.
Rapid assessment and documentation are crucial due to the potential for life-threatening conditions.
Used when a patient presents for evaluation of epigastric pain.
Document history, examination findings, and medical decision-making.
Internal medicine and gastroenterology may have specific documentation needs.
Document the characteristics of the epigastric pain, including onset, duration, intensity, and any associated symptoms. Include any relevant diagnostic findings.
