ICD Code R10.13

ICD code R10.13 is used to identify and classify epigastric pain, which refers to discomfort or pain located in the upper central region of the abdomen, just below the ribcage. This code helps healthcare providers document and communicate the specific nature of a patient's abdominal pain for diagnostic, treatment, and billing purposes.

1. Localized Pain: Use the ICD code when the patient reports pain specifically located in the epigastric region, which is the upper central region of the abdomen.

2. Pain Characteristics: The pain may be described as sharp, dull, burning, or aching. It is important to document the nature of the pain as reported by the patient.

3. Duration and Frequency: Consider the ICD code if the epigastric pain is persistent, recurrent, or has a significant duration that warrants medical attention.

4. Associated Symptoms: The presence of additional symptoms such as nausea, vomiting, bloating, or indigestion can support the use of this ICD code.

5. Exclusion of Other Conditions: Ensure that the pain is not attributable to other specific conditions such as myocardial infarction, pancreatitis, or peptic ulcer disease, unless these are also being coded separately.

6. Clinical Evaluation: The ICD code should be used following a clinical evaluation that includes a physical examination and, if necessary, diagnostic tests to rule out other causes of abdominal pain.

7. Patient History: Consider the patient's medical history, including any previous episodes of similar pain, gastrointestinal disorders, or relevant surgical history.

8. Impact on Daily Activities: Document if the epigastric pain significantly impacts the patient's daily activities or quality of life, justifying the need for medical intervention.

9. Response to Treatment: Note any response to initial treatments or interventions, which can help in determining the appropriateness of using this ICD code for ongoing management.

By adhering to these criteria, healthcare providers can ensure accurate and appropriate use of the ICD code for epigastric pain, facilitating effective communication and billing processes within the healthcare revenue cycle.

For the ICD code R10.13 (Epigastric pain), the relevant CPT codes that may be applicable for treatment or diagnostic procedures include:

1. 99201-99205 - New patient office or other outpatient visit.
2. 99211-99215 - Established patient office or other outpatient visit.
3. 99241-99245 - Office consultation for a new or established patient.
4. 76700 - Ultrasound, abdominal, real-time with image documentation; complete.
5. 76705 - Ultrasound, abdominal, real-time with image documentation; limited.
6. 91010 - Esophageal motility study.
7. 91035 - Esophagogastroduodenoscopy (EGD) with biopsy.
8. 91110 - Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus through ileum, with physician interpretation and report.
9. 74240 - Radiologic examination, gastrointestinal tract, upper; with or without delayed images, with KUB.
10. 74246 - Radiologic examination, gastrointestinal tract, upper; with small intestine follow-through study.

These CPT codes are examples of procedures that may be performed to diagnose or treat the condition associated with ICD code R10.13. The selection of specific CPT codes will depend on the clinical scenario and the healthcare provider's judgment.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes associated with ICD code R10.13. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.