ICD-10 Coding for Intractable Nausea and Vomiting(R11.0, R11.2, T45.1X5A, K31.84)
Complete ICD-10-CM coding and documentation guide for Intractable Nausea and Vomiting. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Intractable Nausea and Vomiting
R11Primary Range
Nausea and vomiting
Covers general nausea and vomiting symptoms, including intractable cases when no specific underlying condition is identified.
Adverse effect of antineoplastic and immunosuppressive drugs
Used when nausea and vomiting are due to chemotherapy or similar treatments.
Cyclical vomiting related to migraines
Applicable when intractable nausea and vomiting are part of cyclical vomiting syndrome associated with migraines.
Gastroparesis
Used when intractable nausea and vomiting are due to gastroparesis, particularly in diabetic patients.
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 the dominant symptom without vomiting. |
|
| R11.2 | Nausea with vomiting, unspecified | Use when both symptoms are present and the cause is unknown. |
|
| T45.1X5A | Adverse effect of antineoplastic and immunosuppressive drugs | Use when symptoms are directly related to chemotherapy. |
|
| K31.84 | Gastroparesis | Use when nausea and vomiting are due to 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 intractable nausea and vomiting
Essential facts and insights about Intractable Nausea and Vomiting
Primary ICD-10-CM Codes for intractable nausea and vomiting
Decision Criteria
documentation Criteria
- Document 'intractable' to indicate severity.
Applicable To
- Intractable nausea
Excludes
- Vomiting alone (R11.10)
Clinical Validation Requirements
- Documented nausea lasting more than 3 days unresponsive to standard antiemetics.
Code-Specific Risks
- Risk of under-documenting severity if 'intractable' is not specified.
Coding Notes
- Ensure 'intractable' is documented to justify severity.
R11.2 - Nausea with vomiting, unspecified
Use when both symptoms are present and the cause is unknown.
Applicable To
- Intractable nausea with vomiting
Excludes
- Nausea without vomiting (R11.0)
Clinical Validation Requirements
- Persistent symptoms for more than 72 hours with significant weight loss.
Coding Notes
Document any failed treatments to support intractability.
T45.1X5A - Adverse effect of antineoplastic and immunosuppressive drugs
Use when symptoms are directly related to chemotherapy.
Applicable To
- Chemotherapy-induced nausea and vomiting
Clinical Validation Requirements
- Temporal relationship between chemotherapy and symptom onset.
Coding Notes
Sequence T45.1X5A before R11 codes.
K31.84 - Gastroparesis
Use when nausea and vomiting are due to gastroparesis.
Applicable To
- Diabetic gastroparesis
Clinical Validation Requirements
- Gastric emptying study showing delayed gastric emptying.
Coding Notes
Document diabetic control measures if applicable.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for antineoplastic chemotherapy
Z51.11Differential 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 Intractable Nausea and Vomiting to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R11.0.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or incorrect reimbursement.
Mitigation Strategy
Always assess for underlying conditions., Document any diagnostic tests performed.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Identify and code the underlying condition as primary.
Impact
Reimbursement: Claims may be denied if severity is not documented., Compliance: Failure to meet documentation standards., Data Quality: Lack of severity documentation affects clinical data accuracy.
Mitigation Strategy
Ensure 'intractable' is documented to justify severity and treatment.
Impact
Failure to document 'intractable' can lead to audit flags.
Mitigation Strategy
Implement documentation checklists to ensure severity is noted.
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 Intractable Nausea and Vomiting, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Intractable Nausea and Vomiting
Use these documentation templates to ensure complete and accurate documentation for Intractable Nausea and Vomiting. These templates include all required elements for proper coding and billing.
Intractable nausea and vomiting in chemotherapy patient
Specialty: OncologyRequired Elements
- Chemotherapy regimen and dates
- Symptom onset and duration
- Failed antiemetic treatments
- Patient's hydration status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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