ICD-10 Coding for Abdominal Mass(R19.00, R19.06)
Complete ICD-10-CM coding and documentation guide for Abdominal Mass. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abdominal Mass
R19.0-Primary Range
Other and unspecified intra-abdominal mass and lump
This range covers unspecified and specific abdominal masses, essential for coding when the mass is the primary focus without a confirmed etiology.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R19.00 | Intra-abdominal mass, unspecified site | Use when the mass is detected but the specific site is not documented. |
|
| R19.06 | Epigastric mass | Use when the mass is specifically located in the epigastric region. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for abdominal mass
Essential facts and insights about Abdominal Mass
Primary ICD-10-CM Codes for abd mass
Decision Criteria
documentation Criteria
- Document specific location and characteristics of the mass.
Applicable To
- Abdominal mass NOS
Excludes
- Neoplasm related masses (C00-D49)
Clinical Validation Requirements
- Physical exam findings of a palpable mass
- Imaging studies confirming presence of mass
Code-Specific Risks
- Overuse due to lack of specific site documentation
Coding Notes
- Ensure documentation specifies the quadrant or site to avoid unspecified coding.
R19.06 - Epigastric mass
Use when the mass is specifically located in the epigastric region.
Applicable To
- Epigastric lump
Excludes
- Neoplasm related masses (C00-D49)
Clinical Validation Requirements
- Physical exam findings of a mass in the epigastric region
- Imaging studies confirming presence of mass
Coding Notes
Ensure documentation specifies the epigastric location to use this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abdominal Mass to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R19.00.
Impact
Clinical: May lead to incorrect diagnosis and treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Train staff on the importance of detailed documentation., Use templates to ensure all necessary details are captured.
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreases data accuracy for clinical research and audits.
Mitigation Strategy
Document and code the specific quadrant to avoid unspecified coding.
Impact
High risk of audits due to frequent use of unspecified codes.
Mitigation Strategy
Encourage detailed documentation and use of specific codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abdominal Mass, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abdominal Mass
Use these documentation templates to ensure complete and accurate documentation for Abdominal Mass. These templates include all required elements for proper coding and billing.
Surgical Pre-Op Assessment
Specialty: SurgeryRequired Elements
- Location of mass
- Size and consistency
- Imaging results
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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