Every year, August is observed as “Gastroparesis Awareness Month” – a time to create global awareness about gastroparesis, a chronic gastrointestinal disorder, to improve understanding and management of the disease and encourage preventive strategies. Sponsored by the International Foundation for Functional Gastrointestinal Disorders (IFFGD), the awareness campaign brings attention to gastroparesis diagnosis, treatment, and quality of life issues. Gastroparesis is a long-term (chronic) condition that affects the normal spontaneous movement of the muscles (motility) in your stomach. Although there is no specific cure for this gastro-intestinal disorder, following a well-balanced nutritional diet along with medications can help to control symptoms in the long-run. Appropriate and timely treatment for gastroparesis can relieve symptoms. For correct clinical documentation of this chronic gastrointestinal disorder, physicians can consider medical billing outsourcing services.

Gastroparesis

Also known as stomach paralysis, the condition occurs when the stomach’s normally occurring contractions are not working properly. Food passes through the stomach more slowly than usual. Reports suggest that about 5 million people in the United States are living with symptoms of gastroparesis. About 1 in 4 adults have symptoms that resemble those of gastroparesis. Primary symptoms of this condition include heartburn or acid reflux, vomiting, nausea, abdominal pain and bloating, feeling of fullness after eating just a few bites, loss of appetite, changes in blood sugar levels, weight loss and malnutrition. These symptoms can be mild or severe, and tend to come and go. The monthly campaign aims to highlight the burdens faced by patients with a chronic digestive disorder like gastroparesis and make them more aware about advanced treatment, prevention, better research and support to improve the quality of life.

The exact cause of gastroparesis is unknown. But in most cases, the condition is caused by damage to the vagus nerve (a nerve that controls the stomach muscles). When this nerve doesn’t work well, food moves too slowly or stops moving. The vagus nerve can be damaged by diseases such as diabetes, or by surgery to the stomach or small intestine. Some of the other potential causes include – uncontrolled diabetes, infection, (usually a virus), scleroderma (a connective tissue disease), hypothyroidism, nervous system diseases (such as Parkinson’s disease or multiple sclerosis) and use of certain medications (such as antidepressants, calcium channel blockers, clonidine, dopamine agonists, lithium, nicotine, and progesterone) that slow the rate of stomach emptying.

Diagnosis of gastroparesis may begin with a detailed review of symptoms and physical examination. Physicians may recommend a wide range of diagnostic tests to be performed to rule out conditions that may cause similar symptoms. These tests and procedures include – Gastric emptying study, Upper gastrointestinal (GI) endoscopy, Ultrasound, Upper gastrointestinal series, Breath test, Gastric manometry, Small intestine X-ray, CT scan and MRI scan. Treatment for this gastric condition may begin with identifying the underlying condition. If diabetes is causing your gastroparesis, the physician may suggest steps that will help you control your blood sugar levels.

Treatment for gastroparesis includes dietary changes, medication and endoscopic treatment. Maintaining adequate nutrition is an important part of the treatment. Physicians may recommend serious diet changes such as consuming nutrient-rich, high calorie foods that are easier to digest. Dietitians may also advise patients to eat smaller meals more frequently, chew food thoroughly, eat well-cooked fruits and vegetables, and avoid fibrous fruits and vegetables. In addition, medications to control nausea and vomiting and to stimulate the stomach muscles may also be given.

Gastroenterologists providing specialized treatment to gastroparesis patients are reimbursed for their services. The diagnosis, screening tests and other procedures must be carefully documented using the appropriate medical codes. Medical billing and coding services offered by experienced providers can assist physicians in using the right ICD-10 codes for their medical billing process.

The ICD-10-CM diagnosis code for gastroparesis is K31.84. When coding gastroparesis, the medical coder is required to code diabetes by type as well, if the doctor has recorded diabetes as an underlying condition.

Two conditions related to gastroparesis that must be coded are bezoars and ileus – the former signifies undigested food in the stomach that may have solidified and cause nausea and vomiting, and the latter is the medical term for lack of movement in the intestines that causes a build-up and blockage of food material leading to intestinal obstruction. Bezoars have to be coded as foreign bodies using ICD-10-CM code categories such as:

  • T18.2 – foreign body in stomach
  • T18.3 – foreign body in small intestine
  • T18.9 – foreign body in alimentary tract, part unspecified

Ileus can occur as a side effect after surgery but there may be other causes as well. If the physician confirms the ileus is a post-operative complication without obstruction, coders can report

  • K91.89, other postprocedural complications and disorders of digestive system, and
  • K56.7, ileus, unspecified

If the postprocedural ileus causes an obstruction with the physician documenting it as a complication, coders are advised to use only code K91.3, postprocedural intestinal obstruction.

ICD-10 codes that may apply include –

  • E08.43 – Diabetes mellitus due to underlying condition with diabetic autonomic (poly) neuropathy
  • E09.43 – Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
  • E10.43 – Type 1 diabetes mellitus with diabetic autonomic (poly) neuropathy
  • E11.43 – Type 2 diabetes mellitus with diabetic autonomic (poly) neuropathy
  • E13.43 – Other specified diabetes mellitus with diabetic autonomic (poly) neuropathy
  • R11.0 – R11.2 – Nausea and vomiting

The month of August was first designated as “Gastroparesis Awareness Month” on July 12, 2016 by the then U.S. Senator Tammy Baldwin (WI) introducing a statement for the record on behalf of the millions of Americans affected by gastroparesis recognizing National Gastroparesis Awareness Month. The theme for the 2018 monthly campaign is – “Make Patient Voices Heard” which aims to coalesce and amplify the voices of gastroparesis patients around the world, who may not otherwise be heard.

In recognition of the third annual Gastroparesis Awareness Month in 2018, IFFGD plans to launch a campaign to elevate the voices of patients and share their stories, needs, and hopes for the future – using the hashtag – #HearMeGP. Through this campaign, IFFGD aims to bring together patients, their family members and friends, and other supporters to raise the voice of the gastroparesis community.

Join “Gastroparesis Awareness Month” campaign in August. Make an effort to generate awareness about this gastro-intestinal disorder and educate people about managing this disease.