ICD-10 Coding for Emesis(R11.2, R11.10, K92.0)
Complete ICD-10-CM coding and documentation guide for Emesis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Emesis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R11.2 | Nausea with vomiting, unspecified | Use when both nausea and vomiting are present without a more specific cause. |
|
| R11.10 | Vomiting, unspecified | Use when vomiting is present without accompanying nausea. |
|
| K92.0 | Hematemesis | Use when vomiting includes blood, confirmed by clinical tests. |
|
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 nausea with vomiting
Essential facts and insights about Emesis
Primary ICD-10-CM Codes for emesis
Decision Criteria
clinical Criteria
- Presence of both nausea and vomiting
Applicable To
- Nausea with vomiting
Excludes
- Vomiting alone (R11.10)
Clinical Validation Requirements
- Documentation of nausea and vomiting episodes
- Absence of a more specific diagnosis
Code-Specific Risks
- Risk of undercoding if specific cause is documented but not coded.
Coding Notes
- Ensure to document both symptoms if using R11.2.
R11.10 - Vomiting, unspecified
Use when vomiting is present without accompanying nausea.
Applicable To
- Vomiting without nausea
Excludes
- Nausea with vomiting (R11.2)
Clinical Validation Requirements
- Documentation of vomiting episodes without nausea
Coding Notes
Ensure vomiting is documented without nausea.
K92.0 - Hematemesis
Use when vomiting includes blood, confirmed by clinical tests.
Applicable To
- Vomiting of blood
Excludes
- Gastrointestinal hemorrhage, unspecified (K92.2)
Clinical Validation Requirements
- Documentation of blood in vomit
- Positive guaiac test or endoscopy findings
Coding Notes
Ensure to document the presence of blood in vomit.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dehydration
E86.0Differential 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 Emesis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R11.2.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Cross-check documentation for both symptoms., Educate staff on correct code usage.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation clearly states both symptoms are present.
Impact
Failure to sequence underlying conditions before emesis codes.
Mitigation Strategy
Educate coders on sequencing rules and provide regular audits.
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 Emesis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Emesis
Use these documentation templates to ensure complete and accurate documentation for Emesis. These templates include all required elements for proper coding and billing.
Patient with chemotherapy-induced vomiting
Specialty: OncologyRequired Elements
- Number of vomiting episodes
- Response to antiemetics
- Presence of dehydration
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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