2025 ICD-10-CM code R11
(Active) Effective Date: N/A Revision Date: N/A Symptoms - Symptoms and signs involving the digestive system and abdomen (R10-R19) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) Feed
Nausea and vomiting.
Modifiers might be applicable depending on the context and the treatment provided.For example, modifiers related to the place of service or the type of treatment may be necessary.
Medical necessity for treatment of nausea and vomiting is established based on the patient's clinical presentation, the severity of the symptoms, and the presence of any associated conditions that require treatment.For instance, if the patient is severely dehydrated due to vomiting, intravenous fluids would be medically necessary.If the cause of the vomiting is a serious medical condition, the treatment of that condition would be medically necessary.
The clinical responsibility for managing nausea and vomiting depends on the underlying cause.In many cases, primary care physicians will address the symptoms and initiate investigations to determine the etiology.If the cause is serious, referral to specialists such as gastroenterologists or surgeons may be needed.
- Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
- R10-R19
In simple words: Nausea is that sick feeling in your stomach, like you're about to throw up. Vomiting is actually throwing up.Many things can cause these, from a simple tummy bug to more serious problems.If you're unsure why you're feeling sick, see a doctor.
Nausea and vomiting are common symptoms that can be caused by a wide variety of conditions, ranging from mild infections to serious medical issues.Nausea is characterized by an unpleasant feeling of queasiness or sickness in the stomach, often preceding vomiting. Vomiting is the forceful expulsion of stomach contents through the mouth.The causes are diverse and may include gastrointestinal infections, food poisoning, pregnancy, migraines, medications, motion sickness, and various systemic illnesses.Differentiating between the specific etiology requires thorough clinical assessment, possibly involving laboratory tests and imaging studies.
Example 1: A patient presents to the emergency room with severe nausea and vomiting following a suspected case of food poisoning. The patient reports consuming contaminated food several hours prior to symptom onset.R11 is used to code the symptoms, alongside additional codes for food poisoning if identified., A pregnant woman in her first trimester experiences persistent morning sickness, characterized by nausea and occasional vomiting.R11 can be used to document the symptoms, though other codes might be considered dependent on the severity and any potential complications., A patient undergoing chemotherapy for cancer experiences severe nausea and vomiting as a side effect of the treatment. R11 can be used in conjunction with codes for chemotherapy-induced nausea and vomiting.
A complete history and physical examination should be documented, including the onset, duration, frequency, and severity of nausea and vomiting.Details about any associated symptoms (e.g., diarrhea, abdominal pain, fever, headache) should also be recorded.The results of any diagnostic tests (e.g., blood work, imaging studies) should be documented. If a specific underlying condition is identified, the appropriate code for that condition should be documented in addition to R11.
** The use of R11 should be carefully considered.If a definitive diagnosis is established, it should be coded rather than R11. This code should be used judiciously and only when other more specific codes are not appropriate.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Gastroenterology, Obstetrics and Gynecology, Oncology, Emergency Medicine
- Place of Service:Office, Emergency Room - Hospital, Inpatient Hospital, Outpatient Hospital, Home