Abdominal Pain ICD-10-CM Codes

What ICD-10 Codes are Used for Abdominal Pain 

Abdominal pain is a common symptom that can arise from various underlying conditions. In medical coding, the International Classification of Diseases, Tenth Revision, and Clinical Modification (ICD-10-CM) codes are utilized to accurately identify and document abdominal pain. These codes provide essential information for healthcare professionals to diagnose and treat patients effectively.
Here are the commonly used Abdominal Pain ICD Codes: 

R10.0 - Acute abdomen

This code indicates sudden and severe abdominal pain, often associated with a surgical emergency. It signifies the need for urgent medical attention and potential surgical intervention.

R10.11 - Right upper quadrant pain

It describes pain in the upper right side of the abdomen, often linked to conditions affecting the liver, gallbladder, or right kidney. Clinical evaluation is necessary to determine the specific cause and initiate appropriate management.

R10.12 - Left upper quadrant pain

This code represents pain in the upper left side of the abdomen, which can be caused by conditions affecting the spleen, stomach, or left kidney. Proper evaluation is required to identify the underlying cause and provide targeted treatment.

R10.2 - Pelvic and perineal pain

It encompasses pain in the pelvic region, including the lower abdomen and perineum. This code is used when the exact cause of the pain is not specified, and further investigation is needed to determine the underlying condition.

R10.30 - Lower abdominal pain, unspecified

When the exact location or cause of the abdominal pain is not specified, this code is utilized. It indicates the presence of pain in the lower abdomen, requiring further assessment to determine the etiology.

R10.31 - Right lower quadrant pain

This code signifies pain in the lower right side of the abdomen. It can be associated with conditions such as appendicitis, ovarian cysts, or inflammation of the right colon. Accurate diagnosis is crucial for appropriate management.

R10.32 - Left lower quadrant pain

It represents pain in the lower left side of the abdomen, often associated with conditions like diverticulitis, ovarian cysts, or inflammation of the left colon. Prompt evaluation is essential for determining the specific cause and initiating targeted treatment.

R10.84 - Generalized abdominal pain

This code is used when a patient experiences pain throughout the abdomen without identifying a specific location or cause. It necessitates a thorough evaluation to determine the underlying condition and implement appropriate management strategies.

R10.9 - Unspecified abdominal pain

When the information available is insufficient to specify the exact nature or location of the abdominal pain, this code is assigned. Further assessment is necessary to establish the cause and guide appropriate treatment.

R07.9 - Chest pain, unspecified

Although not directly related to abdominal pain, this code is occasionally used when abdominal pain is referred to the chest area. It signifies the need for a comprehensive evaluation to determine the cause of the pain.

Which Abdominal Pain  ICD codes are Billable: 

R10.0 - Acute abdomen

This code is billable as it represents a serious condition requiring urgent medical attention and potential surgical intervention. Reimbursement can be obtained for the evaluation and management services provided for patients with acute abdominal pain.

R10.11 - Right upper quadrant pain

Yes, this code is billable as it indicates a specific location of pain in the upper right abdomen. It helps identify potential underlying causes, such as liver, gallbladder, or kidney issues, which may require further diagnostic procedures and treatment.

R10.12 - Left upper quadrant pain

Yes, this code is billable as it specifies the location of pain in the upper left abdomen. Similar to R10.11, it aids in identifying potential causes related to the spleen, stomach, or left kidney, allowing for appropriate evaluation and treatment.

R10.2 - Pelvic and perineal pain

Yes, this code is billable as it denotes pain in the pelvic region, including the lower abdomen and perineum. It assists in identifying potential gynecological or urological causes, enabling proper evaluation and management.

R10.30 - Lower abdominal pain, unspecified

Yes, this code is billable as it signifies pain in the lower abdomen without a specific location or cause specified. It allows further investigation and assessment to determine the underlying condition and appropriate treatment.

R10.31 - Right lower quadrant pain

Yes, this code is billable as it indicates a specific location of pain in the lower right abdomen. It assists in identifying potential causes such as appendicitis, ovarian cysts, or inflammation of the right colon, guiding further evaluation and treatment.

R10.32 - Left lower quadrant pain

Yes, this code is billable as it specifies the location of pain in the lower left abdomen. It helps identify potential causes like diverticulitis, ovarian cysts, or inflammation of the left colon, aiding in appropriate evaluation and management.

R10.84 - Generalized abdominal pain

Yes, this code is billable as it indicates pain throughout the entire abdomen without a specific location specified. It allows further investigation to determine the underlying cause, leading to appropriate evaluation and treatment.

R10.9 - Unspecified abdominal pain

Yes, this code is billable as it represents abdominal pain without sufficient information to specify the exact nature or location. It necessitates further assessment to determine the cause and guide appropriate evaluation and treatment.

R07.9 - Chest pain, unspecified

Yes, this code is billable, although it is not directly related to abdominal pain. It indicates chest pain when abdominal pain is referred to the chest area. It requires comprehensive evaluation to determine the cause of the referred pain and guide appropriate management.

Clinical Information

• Abdominal pain is a common symptom that can be caused by various underlying conditions.
• Gathering detailed clinical information to diagnose and treat abdominal pain accurately is essential.
• The pain's location, intensity, and character can provide valuable insights into the potential causes.
• Associated symptoms such as nausea, vomiting, fever, or changes in bowel movements should be noted.
• Medical history, including past surgeries, gastrointestinal disorders, and family history, can offer important clues.
• Inquiring about recent trauma, dietary changes, medication use, or exposure to toxins is crucial.
• Physical examination findings such as tenderness, guarding, or abnormal masses should be documented.
• Diagnostic tests such as laboratory workup, imaging studies (e.g., ultrasound, CT scan), or endoscopic procedures may be necessary.
• Clinical information should be collected systematically and organized to facilitate accurate coding and billing.
• Thorough clinical assessment documentation helps in selecting the appropriate ICD-10-CM codes for billing and reimbursement purposes.
• Effective communication among healthcare providers ensures comprehensive evaluation and proper management of patients with abdominal pain.

Synonyms Include:

• Stomach ache
• Belly pain
• Abdominal discomfort
• Tummy ache
• Gastric pain
• Gut pain
• Midsection pain
• Visceral pain