ICD-10 Coding for Indigestion(K30)
Complete ICD-10-CM coding and documentation guide for Indigestion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Indigestion
K20-K31Primary Range
Diseases of esophagus, stomach and duodenum
This range includes codes for various gastrointestinal conditions, including functional dyspepsia (K30).
Key Information: ICD-10 code for indigestion
Essential facts and insights about Indigestion
Primary ICD-10-CM Code for indigestion
Decision Criteria
clinical Criteria
- Symptoms persisting for more than 3 months with normal endoscopy
documentation Criteria
- Absence of structural disease and negative H. pylori test
Applicable To
- Non-ulcer dyspepsia
- Idiopathic dyspepsia
Clinical Validation Requirements
- Symptoms persisting for more than 3 months
- Normal endoscopy findings
- Negative H. pylori test
Code-Specific Risks
- Confusion with GERD or non-specific dyspepsia codes
- Incorrect use without confirming functional dyspepsia criteria
Coding Notes
- Ensure documentation specifies 'functional dyspepsia' and excludes structural disease.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Persons encountering health services in other specified circumstances
Z76.89Differential 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 Indigestion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K30.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Use specific terms like 'functional dyspepsia'., Document all relevant diagnostic tests.
Impact
Reimbursement: Incorrect DRG assignment can affect reimbursement., Compliance: May lead to compliance issues during audits., Data Quality: Affects accuracy of clinical data and patient records.
Mitigation Strategy
Use K21.9 if GERD is confirmed by symptoms and diagnostic tests.
Impact
Using K30 without confirming functional dyspepsia criteria.
Mitigation Strategy
Ensure documentation includes symptom duration and normal endoscopy.
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 Indigestion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Indigestion
Use these documentation templates to ensure complete and accurate documentation for Indigestion. These templates include all required elements for proper coding and billing.
Functional Dyspepsia Diagnosis
Specialty: GastroenterologyRequired Elements
- Symptom duration
- Endoscopy findings
- H. pylori test results
- Exclusion of other conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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