Vomiting is not a pleasant subject to discuss but is a very important condition that can occur as a result of a variety of conditions. Vomiting is also known as emesis (or “throwing up”), which is the involuntary, expulsion of the stomach’s contents through the mouth and sometimes the nose (“expulsion is considered spontaneous rejection”). Vomiting ICD-9 - 787.03 (vomiting alone) and ICD-10 - R11.10 (vomiting unspecified) is in the top 30 list of diagnosis codes identified in emergency medicine diagnosis coding performed at McKesson.
It is highly recommended to seek prompt medical attention if vomiting is accompanied by other warning signs, such as chest pain, severe abdominal pain or cramping, blurred vision, fainting, confusion, cold, clammy pale skin, high fever and stiff neck and fecal material or fecal odor in the vomit.1 The feeling that one is about to vomit is called nausea, which often precedes, but does not always lead to, vomiting. Antiemetic is an agent that prevents or relieves nausea and vomiting and is sometimes necessary to suppress nausea and vomiting.
"The character and severity of symptoms depend on the nature of the causative agent, the duration of its action, the patient’s resistance, and the extent of gastrointestinal involvement. Onset is often sudden and sometimes dramatic, with anorexia, nausea, vomiting, borborygmi (a gargling, splashing sound normally heard over the large intestine caused by the passage of gas through the liquid contents of the intestine), abdominal cramps and diarrhea."2
Supportive treatment is really important for the patient experiencing vomiting and bed rest and convenient access to a toilet or bedpan is really desirable. With the possibility of fluid loss, it is important to take frequent sips of water to help improve volume replacement. However, if severe, fluid replacement may be required via intravenous access.
There is a one-to-one crosswalk from ICD-9 to ICD-10 for vomiting, not otherwise specified (NOS), see table below. However, both ICD-9 and ICD-10 contain many other types and reasons for vomiting including, but not limited to, what is shown on the table below.
|ICD-9 Code||ICD-9 Look up and Description||ICD-10 Look up, Code and Description|
787.03 – Vomiting alone
Look up as; Vomiting
Look up as; Vomiting – R11.10
787.02 – Nausea alone
Look up as; Nausea – see also vomiting; nausea
Look up as; Nausea (without vomiting) – R11.0
787.04 – Bilious emesis
Look up as; Vomiting, bilious (Cause unknown)
Look up as; Vomiting, bilious (cause unknown) – R11.14
787.01– Nausea and Vomiting
Look up as; Vomiting, with nausea
Look up as; Vomiting, with nausea – R11.2
It is imperative that the provider document exactly what the examination and the diagnostic studies’ findings are, if any, to determine the exact course of action for the condition presented or defined after study. This will also allow the coding staff to select the most appropriate ICD-10 diagnosis code for reporting the claim for reimbursement.
Robert P. Bunting CPC, COC, CHC, CEDC, CEMC, CAC, CACO Compliance Director – Emergency Medicine
- ICD-10-CM, 2014 Complete Draft Code Set, Chapter 18, “Symptoms, Signs and Abnormal Clinical and Laboratory Findings” (R00 – R99), AAPC, Optuminsight 2013. Page 791.
- ICD-9-CM, 2014, Sixth Edition, 9th Revision, Clinical Modification, Chapter 16, “Symptoms, Signs and Ill-defined Conditions” Editor – Anita C. Hart, Optuminsight August 2013. Pages 780-799.
- Symptoms - Nausea and vomiting. Mayo Clinic Online.