ICD-10 Coding for Right Abdominal Pain(R10.11, R10.31)
Complete ICD-10-CM coding and documentation guide for Right Abdominal Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Abdominal Pain
R10.0-R10.9Primary Range
Abdominal and pelvic pain
This range includes codes for various types of abdominal pain, including specific quadrant pain.
Diseases of appendix
Includes codes for appendicitis, which is a common differential diagnosis for right lower quadrant pain.
Disorders of gallbladder, biliary tract and pancreas
Includes codes for cholecystitis and biliary colic, common differentials for right upper quadrant pain.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R10.11 | Right upper quadrant pain | Use when pain is localized to the right upper quadrant with supporting clinical findings. |
|
| R10.31 | Right lower quadrant pain | Use when pain is localized to the right lower quadrant with supporting clinical findings. |
|
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 right upper quadrant pain
Essential facts and insights about Right Abdominal Pain
Primary ICD-10-CM Codes for right abd pain
Decision Criteria
clinical Criteria
- Presence of RUQ pain with postprandial exacerbation and jaundice.
Applicable To
- Pain in the right upper quadrant of the abdomen
Excludes
- Pain in other parts of the abdomen
Clinical Validation Requirements
- Pain worsens after fatty meals
- Positive Murphy’s sign
- Elevated bilirubin levels
Code-Specific Risks
- Risk of using unspecified codes when quadrant is documented
Coding Notes
- Ensure documentation specifies right upper quadrant to avoid unspecified codes.
R10.31 - Right lower quadrant pain
Use when pain is localized to the right lower quadrant with supporting clinical findings.
Applicable To
- Pain in the right lower quadrant of the abdomen
Excludes
- Pain in other parts of the abdomen
Clinical Validation Requirements
- Migration of pain from periumbilical area
- Alvarado Score ≥7
- WBC count >10,000
Coding Notes
Ensure documentation specifies right lower quadrant to avoid unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Rebound tenderness
R10.812Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Abdominal Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.11.
Impact
Clinical: May lead to misdiagnosis or delayed treatment., Regulatory: Increased risk of audit and compliance issues., Financial: Potential for reduced reimbursement due to unspecified coding.
Mitigation Strategy
Train staff on the importance of detailed documentation., Use templates to ensure all necessary details are captured.
Impact
Reimbursement: Unspecified codes may lead to lower reimbursement rates., Compliance: Increased risk of audit and non-compliance., Data Quality: Decreases the specificity and accuracy of clinical data.
Mitigation Strategy
Always use the most specific code available, such as R10.11 or R10.31.
Impact
High risk of audit when unspecified codes are used despite available documentation.
Mitigation Strategy
Ensure documentation specifies the exact location of pain and associated symptoms.
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 Right Abdominal Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Abdominal Pain
Use these documentation templates to ensure complete and accurate documentation for Right Abdominal Pain. These templates include all required elements for proper coding and billing.
Right Lower Quadrant Pain
Specialty: Emergency MedicineRequired Elements
- Location of pain
- Severity and quality
- Associated symptoms
- Physical exam findings
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Right Abdominal Pain? Ask your questions below.