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v1.0.0
ICD-10 Guide
ICD-10 CodesR10.8

R10.8

Other abdominal pain

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

Code Description

ICD-10 R10.8 is a billable code used to indicate a diagnosis of other abdominal pain.

Key Diagnostic Point:

R10.8 is used to classify abdominal pain that does not fit into more specific categories defined by other ICD-10 codes. This code encompasses a variety of abdominal pain symptoms that may arise from numerous underlying conditions, including gastrointestinal disorders, musculoskeletal issues, or even referred pain from other organ systems. Patients may present with vague or atypical abdominal pain that does not localize to a specific quadrant or does not correlate with common diagnoses such as appendicitis, cholecystitis, or pancreatitis. The clinical context is crucial, as the pain may be acute or chronic, and associated symptoms such as nausea, vomiting, or changes in bowel habits may provide additional diagnostic clues. Laboratory findings may include abnormal liver function tests, elevated inflammatory markers, or imaging results that do not conclusively indicate a specific pathology. Accurate documentation of the patient's history, physical examination findings, and any diagnostic tests performed is essential for appropriate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Vague symptomatology that can overlap with multiple conditions
  • Need for thorough documentation to support the diagnosis
  • Potential for misclassification with more specific abdominal pain codes
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation supporting the diagnosis of 'other abdominal pain'
  • Failure to specify the nature or duration of the pain
  • Misuse of R10.8 when a more specific code is applicable
  • Lack of correlation between clinical findings and the diagnosis

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of present illness, including onset, duration, and characteristics of pain; review of systems; and any relevant past medical history.

Common Clinical Scenarios

Patients presenting with chronic abdominal pain without a clear diagnosis, requiring extensive workup.

Billing Considerations

Consideration of psychosomatic factors or functional gastrointestinal disorders that may contribute to symptoms.

Emergency Medicine

Documentation Requirements

Acute assessment of abdominal pain, including vital signs, physical examination findings, and any immediate interventions or imaging performed.

Common Clinical Scenarios

Patients with acute abdominal pain presenting to the emergency department, requiring rapid evaluation and management.

Billing Considerations

Timeliness of documentation is critical, as emergency settings often involve rapid decision-making and treatment.

Coding Guidelines

Inclusion Criteria

Use R10.8 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Use R10
  • 8 when abdominal pain is present but does not fit into more specific categories

Exclusion Criteria

Do NOT use R10.8 When
No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used when evaluating a patient with nonspecific abdominal pain in an outpatient setting.

Documentation Requirements

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

Specialty Considerations

Internal medicine providers should ensure comprehensive documentation to support the visit level.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more granular coding of abdominal pain, but R10.8 remains a catch-all for nonspecific cases, necessitating careful documentation to avoid misclassification.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more granular coding of abdominal pain, but R10.8 remains a catch-all for nonspecific cases, necessitating careful documentation to avoid misclassification.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more granular coding of abdominal pain, but R10.8 remains a catch-all for nonspecific cases, necessitating careful documentation to avoid misclassification.

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 I use R10.8 instead of a more specific abdominal pain code?

Use R10.8 when the abdominal pain is nonspecific and does not fit into any other defined categories, ensuring that documentation supports this diagnosis.