R10-R19 — Symptoms and signs involving the digestive system and abdomen
ICD-10-CM codes R10-R19 cover symptoms and signs involving the digestive system and abdomen, within symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified. The block holds 120 codes across 10 categories, of which 99 are billable and 21 are header codes that cannot be submitted on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- congenital or infantile pylorospasm (Q40.0)
- gastrointestinal hemorrhage (K92.0-K92.2)
- intestinal obstruction (K56.-)
- newborn gastrointestinal hemorrhage (P54.0-P54.3)
- newborn intestinal obstruction (P76.-)
- pylorospasm (K31.3)
- signs and symptoms involving the urinary system (R30-R39)
- symptoms referable to female genital organs (N94.-)
- symptoms referable to male genital organs (N48-N50)
Risk adjustment in R10-R19
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
What else to watch in R10-R19
- 26 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 99 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in R10-R19
- R10Abdominal and pelvic pain
- R11Nausea and vomiting
- R12Heartburn
- R13Aphagia and dysphagia
- R14Flatulence and related conditions
- R15Fecal incontinence
- R16Hepatomegaly and splenomegaly, not elsewhere classified
- R17Unspecified jaundice
- R18Ascites
- R19Other symptoms and signs involving the digestive system and abdomen