ICD-10 Coding for Cyclic Vomiting Syndrome(G43.A0, G43.A1, R11.15)
Complete ICD-10-CM coding and documentation guide for Cyclic Vomiting Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cyclic Vomiting Syndrome
G43.A0-G43.A1Primary Range
Codes for cyclic vomiting syndrome associated with migraines
These codes are used when CVS is linked to migraine conditions.
Code for cyclic vomiting syndrome unrelated to migraines
This code is used when CVS is not associated with migraines.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G43.A0 | Cyclic vomiting syndrome with migraine association, not intractable | Use when CVS is associated with migraines and is not intractable. |
|
| G43.A1 | Cyclic vomiting syndrome with migraine association, intractable | Use when CVS is associated with migraines and is intractable. |
|
| R11.15 | Cyclic vomiting syndrome unrelated to migraine | Use when CVS is not associated with migraines. |
|
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 cyclic vomiting syndrome
Essential facts and insights about Cyclic Vomiting Syndrome
Primary ICD-10-CM Codes for cyclic vomiting syndrome
Decision Criteria
clinical Criteria
- Presence of migraine symptoms
Applicable To
- Migraine-associated cyclical vomiting
Excludes
- Cyclic vomiting unrelated to migraine (R11.15)
Clinical Validation Requirements
- Migraine history
- Stereotypical episodes
- Symptom-free intervals
Code-Specific Risks
- Misclassification if migraine history is not documented
Coding Notes
- Ensure migraine history is clearly documented.
G43.A1 - Cyclic vomiting syndrome with migraine association, intractable
Use when CVS is associated with migraines and is intractable.
Applicable To
- Refractory cyclic vomiting with migraine
Excludes
- Cyclic vomiting unrelated to migraine (R11.15)
Clinical Validation Requirements
- Intractable episodes
- Failure of migraine prophylaxis
Coding Notes
Document intractability and treatment resistance.
R11.15 - Cyclic vomiting syndrome unrelated to migraine
Use when CVS is not associated with migraines.
Applicable To
- Cyclic vomiting without migraine
Excludes
- Cyclic vomiting with migraine (G43.A0, G43.A1)
Clinical Validation Requirements
- Absence of migraine history
- Stereotypical episodes
Coding Notes
Ensure no migraine history is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Family history of migraine
Z82.0Differential 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 Cyclic Vomiting Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G43.A0.
Impact
Clinical: Misrepresentation of patient's condition, Regulatory: Potential audit flags, Financial: Incorrect reimbursement
Mitigation Strategy
Review patient history thoroughly, Use structured templates
Impact
Reimbursement: Potential underpayment due to incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Query provider to clarify migraine association.
Impact
Lack of migraine documentation when using G43.A- codes
Mitigation Strategy
Implement mandatory migraine history checks in EHR
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 Cyclic Vomiting Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cyclic Vomiting Syndrome
Use these documentation templates to ensure complete and accurate documentation for Cyclic Vomiting Syndrome. These templates include all required elements for proper coding and billing.
Neurology Progress Note
Specialty: NeurologyRequired Elements
- Chief Complaint
- History of Present Illness
- Assessment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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