Diagnostic Coding for Gastroparesis, A Chronic Gastrointestinal Disorder

by | Published on Aug 4, 2021 | Medical Coding

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Gastroparesis can be extremely debilitating and life-threatening. The signs and symptoms associated with it vary in intensity and frequency. In most cases, the symptoms may occur or aggravate either during or after eating a meal (mainly comprising rich foods, greasy foods, foods with a lot of fiber, and carbonated beverages). The most common symptoms of gastroparesis are nausea, vomiting undigested food, feeling full after eating only a small amount of food, stomach pain, loss of appetite, acid reflux, abdominal bloating, weight loss and malnutrition. Several complications like – dehydration due to continuous vomiting and fluctuations in blood sugar levels may occur as part of the condition that make daily living activities difficult. Physicians treating patients with this health condition have to document it accurately on their medical claims. Gastroenterology medical billing and coding can be challenging. When documenting gastroparesis, you need to include the exact causes, symptoms, diagnosis, screening tests and treatment procedures performed using the correct medical codes. Medical coding outsourcing services provided by a reputable gastroenterology medical billing company can help physicians use the correct codes for their billing purposes.

K31.84 – is the ICD-10 diagnosis code to report gastroparesis.

Also known as delayed gastric emptying, gastroparesis is a chronic condition that affects the motility in the stomach. The muscles of the stomach, controlled by the vagus nerve, normally contract to move food through the gastrointestinal tract. Any specific damage to the vagus nerve causes disruption in the normal functioning of the stomach muscles. There is no specific cure for this gastro-intestinal disorder. Following a balanced nutritional diet along with medications can help control symptoms in the long-run.

Early diagnosis makes treatment easier, which is why awareness about the causes, risk factors, and symptoms of the condition is critical. Diagnosis of gastroparesis includes a detailed physical examination and medical history evaluation. You may have to request blood tests to monitor the patient’s blood sugar levels. Imaging tests like – Gastric emptying study, Upper gastrointestinal (GI) endoscopy, Ultrasound, Upper gastrointestinal series, Gastric manometry and MRI scan would have to be conducted to rule out any structural problems or blockage in the urinary tract.

Treatment for this condition depends on the underlying causes and severity of symptoms. Diabetic patients are usually advised to take adequate steps to control their blood glucose levels to reduce the problems of gastroparesis. Treatment approaches include a combination of modalities like – medications, dietary and lifestyle measures and surgical procedures in some cases. Medications like metoclopramide (Reglan) and erythromycin, prochlorperazine (Compro), ondansetron (Zofran) and diphenhydramine (Benadryl, Unisom) are usually prescribed by physicians to stimulate the stomach muscles. Surgical procedures include – Enteral nutrition, Parenteral nutrition, Gastric electrical stimulation (Enterra) and other procedures.

If the physician has recorded diabetes as an underlying cause for the condition, the medical coder needs to code gastroparesis as well as diabetes by type. Two different conditions such as Bezoars and Ileus must be included as part of the coding. Bezoars refers to a solid mass of indigestible food material that accumulates in the digestive tract, causing nausea and vomiting. Ileus is a term for lack of movement in the intestines that results in a build-up and blockage of food material, leading to intestinal obstruction. The condition can occur as a side effect after surgery. ICD-10-CM codes for Bezoars and Ileus –

  • T18.2 – Foreign body in stomach
  • T18.3 – Foreign body in small intestine
  • T18.9 – Foreign body in alimentary tract, part unspecified
  • K56.7 – Ileus, unspecified
  • K91.89 – Other post-procedural complications and disorders of digestive system

If the post-procedural ileus causes an obstruction with the physician documenting it as a complication, coders are advised to use only code –

  • K91.3 – Post-procedural intestinal obstruction

August Is Observed as Gastroparesis Awareness Month

With an objective to generate better understanding and management of the disease – gastroparesis, August is observed as “Gastroparesis Awareness Month” in the United States. Sponsored by the International Foundation for Functional Gastrointestinal Disorders (IFFGD), the campaign aims to focus attention on important health messages about gastroparesis diagnosis, treatment, and quality of life issues. It aims to improve the understanding of gastroparesis to help patients and families manage the condition, and encourage preventive strategies. The month-long campaign aims to educate the general public about the importance of early diagnosis, treatment and prevention of this stomach disorder.

Reports suggest that up to 5 million people in the United States are impacted by gastroparesis. The condition can occur at any age, but the average age of onset of symptoms is 34 years. Women are more likely to develop gastroparesis than men. Potential causes include – 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.

The 2021 observance in August is a good occasion to support the gastroparesis community by raising awareness of the disease and encouraging research. For three decades, the International Foundation for Functional Gastrointestinal Disorders (IFFGD) – the sponsoring organization for the observance – has been at the forefront in the fight for research to improve diagnostic and treatment options for GI disorders like gastroparesis.

The month of August was at first officially designated as “Gastroparesis Awareness Month” on July 12, 2016 by the then U.S. Senator Tammy Baldwin (WI) by introducing a statement for the record on behalf of the millions of Americans affected by gastroparesis. With sponsorship by IFFGD, Gastroparesis Awareness Month was listed on the U.S. National Health Observances Calendar, beginning in 2016.

Over the years, the scope of the campaign widened with several health care organizations, professionals, individuals, teachers, community groups and others coming together to sponsor health promotion events and stimulate awareness of health issues related to this chronic gastrointestinal disorder. This August, IFFGD will raise awareness to humanize this commonly misunderstood and often misdiagnosed condition by highlighting patient stories throughout the month. The theme for the 2021 campaign is – #ThisIsGP – that provides an opportunity for patients living with gastroparesis to share their stories and experiences with others worldwide. The awareness color for the campaign is “Green”. People can show their support for this campaign by wearing Green custom awareness ribbons or wristbands. Other ways to support the campaign include – joining the conversation about gastroparesis, sharing patient stories, experiences and tips on preventive and management strategies via social media platforms like Facebook and Twitter. People can also login to the IFFGD web site to share their experiences or find resources to work with others to create a meaningful, positive change for everyone affected by gastroparesis.

Participate in Gastroparesis Awareness Campaign This August and Spread Awareness about This Chronic Gastro-Intestinal Disorder!

Meghann Drella

Meghann Drella possesses a profound understanding of ICD-10-CM and CPT requirements and procedures, actively participating in continuing education to stay abreast of any industry changes.

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