Learn about Cannabis Hyperemesis Syndrome (CHS), a condition characterized by cyclical vomiting and abdominal pain associated with chronic cannabis use. This page provides information on CHS diagnosis, clinical documentation, and medical coding for healthcare professionals. Find resources on cannabinoid hyperemesis syndrome symptoms, treatment, and ICD-10 codes relevant to CHS for accurate medical billing and reporting. Understand the connection between chronic cannabis use and CHS to improve patient care and documentation.
Also known as
Nausea and vomiting
Symptoms like nausea and vomiting, often caused by various conditions.
Mental and behavioural disorders due to use of cannabis
Covers mental health issues related to cannabis use, including addiction.
Poisoning by, adverse effect of and underdosing of cannabinoids
Specifically addresses harmful effects from cannabinoid exposure or insufficient dosage.
Follow this step-by-step guide to choose the correct ICD-10 code.
Cyclic vomiting with regular cannabis use?
Yes
Compulsive hot bathing relieves symptoms?
No
Do not code CHS. Code the presenting symptoms and/or underlying condition.
When to use each related code
| Description |
|---|
| Recurring nausea and vomiting related to chronic cannabis use. |
| Recurring episodes of severe nausea and vomiting unrelated to cannabis. |
| Nausea and vomiting due to another identifiable cause. |
Symptoms mimic cyclic vomiting syndrome, leading to misdiagnosis and incorrect coding (R11.10, R11.11 vs. T40.7X5A).
Using unspecified nausea/vomiting codes (R11.0, R11.10, R11.2) when CHS is suspected delays proper diagnosis and treatment.
Insufficient documentation of cannabis use and characteristic symptoms hinders accurate coding and compliance audits (Z72.0).
Q: How to differentiate Cannabis Hyperemesis Syndrome (CHS) from other cyclical vomiting syndromes in a clinical setting?
A: Differentiating Cannabis Hyperemesis Syndrome (CHS) from other cyclical vomiting syndromes like cyclic vomiting syndrome (CVS) and abdominal migraine can be challenging due to overlapping symptoms. Key differentiators for CHS include a history of chronic cannabis use, characteristic prodromal phase of nausea and abdominal pain, compulsive hot bathing behavior that relieves symptoms, and resolution of symptoms with cannabis cessation. Consider incorporating a detailed substance use history, assessment of bathing habits for symptom relief, and evaluating the patient's response to a trial of cannabis abstinence into your diagnostic workup. Explore how detailed patient history and targeted physical exam findings can aid in accurate CHS diagnosis and improve patient outcomes. While laboratory and imaging studies may be used to rule out other conditions, they are not typically diagnostic for CHS. Learn more about the diagnostic criteria for CHS and the importance of ruling out other potential causes of cyclical vomiting.
Q: What are the most effective management strategies for patients presenting with Cannabis Hyperemesis Syndrome (CHS) in the emergency department?
A: Managing acute episodes of Cannabis Hyperemesis Syndrome (CHS) in the emergency department typically involves supportive care focused on symptom relief. This includes intravenous fluid rehydration to address dehydration and electrolyte imbalances, antiemetics such as ondansetron or haloperidol for nausea and vomiting, and anxiolytics like benzodiazepines to manage anxiety and agitation. While hot bathing behavior may provide temporary relief for patients, it's important to discourage this practice due to the risk of burns and dehydration. Consider implementing a patient education strategy that emphasizes the link between cannabis use and CHS symptoms and encourages cessation. Learn more about the long-term management of CHS and the role of behavioral therapies in supporting cannabis abstinence. Explore how integrating substance abuse counseling and support services can improve patient outcomes in the long term.
Patient presents with symptoms consistent with Cannabis Hyperemesis Syndrome (CHS), also known as Cannabinoid Hyperemesis Syndrome. The patient reports cyclical vomiting, nausea, and abdominal pain, specifically noting a history of chronic, heavy cannabis use. The patient describes experiencing temporary relief of symptoms with hot bathing or showering, a hallmark sign of CHS. On physical examination, the patient appears dehydrated with mild epigastric tenderness. Differential diagnoses considered include cyclic vomiting syndrome, gastroenteritis, and other causes of abdominal pain and vomiting. Laboratory tests, including a complete blood count (CBC) and comprehensive metabolic panel (CMP), were ordered to rule out other medical conditions and assess hydration status. Diagnosis of Cannabis Hyperemesis Syndrome is based on the patient's history of regular cannabis use, characteristic symptoms of cyclical vomiting and nausea, compulsive hot bathing behavior, and the absence of other identifiable causes. The patient was advised to cease cannabis use. Treatment plan includes intravenous fluid hydration for dehydration management and antiemetic medication to control nausea and vomiting. Patient education was provided on the association between cannabis use and CHS, emphasizing the importance of cessation for symptom resolution. Follow-up appointment scheduled to monitor symptom improvement and provide further support for cannabis cessation. ICD-10 code T40.7X1A (poisoning by cannabinoids, accidental unintentional) and related billing codes will be applied for documentation and reimbursement purposes.