ICD Code K31.84

ICD code K31.84 is a medical classification used to identify gastroparesis, a condition characterized by delayed gastric emptying in the absence of any mechanical obstruction. This condition can lead to symptoms such as nausea, vomiting, bloating, and abdominal pain, as the stomach muscles fail to function properly, causing food to move slowly or stop moving through the digestive tract. Proper coding of gastroparesis is crucial for accurate diagnosis, treatment planning, and reimbursement processes within the healthcare revenue cycle.

1. Nausea and Vomiting: Persistent nausea and vomiting that cannot be attributed to other gastrointestinal disorders should be considered as potential indicators.

2. Early Satiety: A sensation of fullness after consuming only a small amount of food, leading to reduced food intake and potential weight loss.

3. Bloating and Abdominal Pain: Frequent bloating and discomfort in the abdominal area, often accompanied by pain, should be evaluated.

4. Delayed Gastric Emptying: Objective evidence of delayed gastric emptying, typically confirmed through gastric emptying studies, is a critical diagnostic criterion.

5. Absence of Mechanical Obstruction: It is essential to rule out any mechanical obstruction in the gastrointestinal tract through appropriate imaging studies.

6. Diabetes Mellitus: A history of diabetes mellitus, particularly poorly controlled diabetes, can be a contributing factor and should be considered in the diagnostic process.

7. Post-Surgical Symptoms: Symptoms that arise following gastric surgery, such as vagotomy or fundoplication, may warrant the use of this code.

8. Idiopathic Causes: In cases where no identifiable cause is found, yet symptoms persist, idiopathic gastroparesis may be diagnosed.

9. Nutritional Deficiencies: Evidence of nutritional deficiencies due to poor absorption and intake should be assessed as part of the diagnostic criteria.

10. Response to Prokinetic Agents: A positive response to prokinetic medications, which aid in gastric motility, can support the diagnosis.

For the ICD code K31.84, which is associated with gastroparesis, the relevant CPT codes that may be applicable for treatment and management include:

1. CPT 43235 - Esophagogastroduodenoscopy (EGD) diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure).

2. CPT 43239 - Esophagogastroduodenoscopy (EGD) with biopsy, single or multiple.

3. CPT 91010 - Esophageal motility study, with interpretation and report.

4. CPT 91020 - Gastric motility (manometric) study, with interpretation and report.

5. CPT 91110 - Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus through ileum, with interpretation and report.

6. CPT 64590 - Insertion or replacement of peripheral or gastric neurostimulator electrode array, open.

7. CPT 64595 - Revision or removal of peripheral or gastric neurostimulator electrode array.

These CPT codes are commonly used in the context of diagnosing and managing gastroparesis, and healthcare providers should ensure accurate coding to facilitate proper billing and reimbursement processes. Always verify with the latest coding guidelines and payer-specific policies, as codes and coverage can change.

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