ICD-10 Coding for Chronic Nausea(R11.0, K31.84, E11.43)
Complete ICD-10-CM coding and documentation guide for Chronic Nausea. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Nausea
R11-R19Primary Range
Symptoms and signs involving the digestive system and abdomen
Includes codes for nausea and vomiting, which are primary symptoms of chronic nausea.
Diseases of esophagus, stomach, and duodenum
Includes gastroparesis, a potential underlying cause of chronic nausea.
Diabetes mellitus
Includes codes for diabetes with complications like gastroparesis, which can cause chronic nausea.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R11.0 | Nausea | Use when nausea is persistent without an identified cause after thorough evaluation. |
|
| K31.84 | Gastroparesis | Use when gastroparesis is confirmed as the cause of nausea. |
|
| E11.43 | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy | Use when diabetes is the underlying cause of gastroparesis. |
|
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 chronic nausea
Essential facts and insights about Chronic Nausea
Primary ICD-10-CM Codes for chronic nausea
Decision Criteria
clinical Criteria
- Nausea without vomiting and no identifiable cause
Applicable To
- Chronic idiopathic nausea
Excludes
- Nausea with vomiting (R11.2)
Clinical Validation Requirements
- Nausea occurring ≥3 days/week for 6+ months
- Normal endoscopy and metabolic panels
Code-Specific Risks
- Incorrect use when an underlying cause is identified
Coding Notes
- Ensure documentation excludes other causes before using R11.0.
K31.84 - Gastroparesis
Use when gastroparesis is confirmed as the cause of nausea.
Applicable To
- Delayed gastric emptying
Excludes
- Diabetic gastroparesis (E11.43)
Clinical Validation Requirements
- Gastric emptying study showing >10% retention at 4 hours
Coding Notes
Sequence diabetes code first if applicable.
E11.43 - Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
Use when diabetes is the underlying cause of gastroparesis.
Applicable To
- Diabetic gastroparesis
Excludes
- Type 1 diabetes mellitus with gastroparesis (E10.43)
Clinical Validation Requirements
- Diabetes diagnosis with gastroparesis symptoms
Coding Notes
Sequence before gastroparesis 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 Chronic Nausea to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R11.0.
Impact
Clinical: Misdiagnosis of the condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure all relevant tests are documented., Include results in the patient's record.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient's condition.
Mitigation Strategy
Use the code for the underlying condition as primary.
Impact
Sequencing symptom codes before underlying conditions.
Mitigation Strategy
Always sequence the underlying condition first.
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 Chronic Nausea, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Nausea
Use these documentation templates to ensure complete and accurate documentation for Chronic Nausea. These templates include all required elements for proper coding and billing.
Chronic Idiopathic Nausea
Specialty: GastroenterologyRequired Elements
- Frequency and duration of nausea
- Normal test results
- Exclusion of other conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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