Every year, the month of August is observed as “Gastroparesis Awareness Month” in the United States. Sponsored by the International Foundation for Functional Gastrointestinal Disorders (IFFGD), the campaign is dedicated to improving understanding and management of the disease. It aims to spread information about the importance of early gastroparesis diagnosis and treatment, and encourage preventive strategies to improve quality of life issues. Gastroparesis is a condition that affects the normal, spontaneous movement of the muscles (motility) in your stomach. In this disease, the stomach cannot empty itself of food in a normal manner.
Also known as stomach paralysis, the condition can directly affect the normal digestion process causing nausea, vomiting and lead to severe variations in blood sugar levels and nutrition. Although there is no specific treatment for this gastro-intestinal disorder, following a well-balanced nutritional diet along with medications can help control symptoms in the long-run. Surgery will be considered as a last option (in extreme cases) when people are unable to tolerate any food or liquids. The type of treatment to be administered may depend on the severity of the condition. For correct clinical documentation of this gastro-intestinal disorder, physicians can consider utilizing outsourced medical billing and coding services.
Reports suggest that about five million people in the United States are living with the debilitating or life-threatening symptoms of gastroparesis. Women are more likely to develop gastroparesis than men. The exact cause of this condition is not clear, but is expected to be caused by the damage to vagus nerve (that controls the stomach muscles) by diseases like diabetes, or by surgery to the stomach or small intestine. The vagus nerve helps manage the complex processes in your digestive tract. When this nerve doesn’t work well, the food moves too slowly or stops moving normally into your small intestine to be digested. 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.
The monthly campaign is the ideal time to educate the general public about the prominent symptoms of this condition and develop strategies to improve diagnosis, treatment, and prevention of this stomach disorder. Primary symptoms of this condition include heartburn, 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.
Gastroparesis diagnosis begins with a physical examination and analysis of previous medical history and symptoms. Physicians may recommend doing certain blood tests, including blood sugar levels. A wide range of diagnostic imaging tests like – Gastric emptying study, Upper gastrointestinal (GI) endoscopy, Ultrasound, Upper gastrointestinal series, Gastric manometry and MRI scan will be conducted. Treatment for this condition may depend on the underlying factors that cause the condition. Diabetic patients should take adequate steps to control their blood glucose levels to reduce the problems of gastroparesis.
Medications to stimulate the stomach muscles like metoclopramide (Reglan) and erythromycin) and control nausea and vomiting like prochlorperazine (Compro), ondansetron (Zofran) and diphenhydramine (Benadryl, Unisom) may be prescribed by physicians. Maintaining adequate nutrition and incorporating dietary changes are the first steps in managing this condition. Physicians may recommend consuming nutrient-rich, high calorie foods that are easier to digest. Dieticians may advise patients to eat well-cooked fruits and vegetables, chew food thoroughly, avoid carbonated drinks, alcohol and smoking, eat smaller meals more frequently and consume a multivitamin daily. In some severe cases, people with this condition may be unable to tolerate any food or liquids. Surgery will be recommended in such cases, wherein the physicians may place a feeding tube (jejunostomy tube) in the small intestine tube that help relieve pressure from gastric contents.
When documenting gastroparesis, gastroenterologists must include the associated causes, symptoms, diagnosis, screening tests and treatment procedures performed using the correct medical codes. Medical billing and coding services provided by a reputable gastroenterology medical billing company can help physicians use the correct codes for their billing purposes.
The ICD-10-CM diagnosis code for gastroparesis is K31.84. If the physician has recorded diabetes as an underlying cause for the condition, the medical coder needs to not only code gastroparesis but also code diabetes by type.
Two different conditions such as – bezoars and ileus must be included as part of the coding. Bezoars refer to a solid mass of indigestible food material that accumulates in your digestive tract, causing nausea and vomiting. 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 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. This means no food material, gas, or liquids can get through. The condition can occur as a side effect after surgery. If ileus is confirmed as a post-operative complication without obstruction, the following codes need to be reported –
- 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 was officially 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. The theme for the 2019 event is – “Education” which aims to join together patients, family members, physicians, nurses, caregivers and others by providing essential educational resources to broaden the understanding about GI disorders and its potential effects on patients. The awareness color for the campaign is “Green”.
In recognition of the fourth annual Gastroparesis Awareness Month, IFFGD is planning to launch a campaign using the hash tag – #GPeducation to increase public knowledge about gastroparesis. As part of the campaign, IFFGD is inviting people to share reliable resources and what they wish to know before being diagnosed with gastroparesis using #GPeducation.
Take part in “Gastroparesis Awareness Month” campaign in August. Make efforts to educate people about this gastro-intestinal disorder.