Find information on chemo-induced nausea (CINV), also known as chemotherapy-induced nausea and vomiting. This resource offers guidance for healthcare professionals on clinical documentation and medical coding related to CINV. Learn about managing chemotherapy-induced nausea and vomiting, including diagnosis codes and best practices for patient care. Explore resources for CINV, including support for healthcare providers and patients experiencing this chemotherapy side effect.
Also known as
Nausea and vomiting
Nausea and vomiting, unspecified
Adverse effect of antineoplastic and immunosuppressive drugs
Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter
Encounter for antineoplastic chemotherapy
Encounter for antineoplastic chemotherapy
Follow this step-by-step guide to choose the correct ICD-10 code.
Is nausea directly related to chemotherapy?
Yes
Is nausea acute (<1 day)?
No
Do NOT code as chemo-induced nausea. Evaluate for other causes.
When to use each related code
| Description |
|---|
| Nausea caused by chemotherapy |
| Nausea and vomiting caused by chemotherapy |
| Anticipatory nausea related to chemotherapy |
Coding CINV without specifying if it's acute, delayed, or anticipatory can lead to inaccurate reimbursement and quality reporting.
Failing to document and code CINV can underestimate the severity of chemotherapy side effects, impacting patient care and resource allocation.
Incorrectly coding the severity of CINV (mild, moderate, severe) affects reimbursement and clinical trial eligibility.
Q: What are the most effective antiemetic guidelines for managing chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy?
A: Current antiemetic guidelines, such as those from the National Comprehensive Cancer Network (NCCN), recommend a combination of antiemetics for highly emetogenic chemotherapy (HEC). This typically includes a 5-HT3 receptor antagonist, a neurokinin-1 receptor antagonist, and a corticosteroid like dexamethasone. For some patients, the addition of olanzapine may be considered. The specific regimen should be tailored to the individual patient's risk factors, including age, comorbidities, and previous CINV experience. Explore how implementing these guideline-based approaches can improve patient outcomes and reduce CINV-related complications. Consider consulting the latest NCCN guidelines for detailed recommendations and specific chemotherapy regimens.
Q: How can I differentiate between anticipatory nausea and vomiting versus acute or delayed CINV in my chemotherapy patients, and what are the best management strategies for each?
A: Anticipatory nausea and vomiting (ANV) typically occurs before chemotherapy administration and is often triggered by previous negative experiences. It's distinct from acute CINV, which develops within 24 hours of chemotherapy, and delayed CINV, which occurs more than 24 hours after treatment. Managing ANV involves behavioral therapies like relaxation techniques and guided imagery, as well as prophylactic antiemetics. Acute and delayed CINV are managed with different combinations of antiemetics depending on the emetogenicity of the chemotherapy regimen. For acute CINV, 5-HT3 receptor antagonists are key, while delayed CINV often benefits from neurokinin-1 receptor antagonists. Learn more about effective strategies for differentiating and managing these various types of CINV to provide personalized patient care.
Patient presents with complaints consistent with chemotherapy-induced nausea and vomiting (CINV). Onset of nausea correlated with recent chemotherapy administration for [Document specific chemotherapy regimen, e.g., FOLFOX regimen for colon cancer]. Patient reports [Describe nausea severity, e.g., mild, moderate, severe] nausea characterized by [Describe nausea characteristics, e.g., a constant queasiness, episodic waves of nausea]. The patient also reports [Document presence and characteristics of vomiting, e.g., no vomiting, two episodes of emesis containing undigested food]. Patient's current antiemetic regimen includes [List current antiemetic medications, dosages, and routes of administration]. Assessment reveals [Document pertinent physical exam findings related to hydration status and abdominal exam, e.g., dry mucous membranes, mild epigastric tenderness on palpation, normal bowel sounds]. Differential diagnosis includes other causes of nausea and vomiting such as medication side effects, infection, and bowel obstruction. Given the temporal relationship to chemotherapy, chemotherapy-induced nausea and vomiting (CINV) is the most likely diagnosis. Plan includes [Outline plan for managing CINV, e.g., adjustment of antiemetic regimen to include a 5-HT3 receptor antagonist and a corticosteroid, patient education on dietary modifications, monitoring for dehydration, and follow-up]. Patient advised to contact the clinic if symptoms worsen or do not improve with the adjusted treatment plan. ICD-10 code R11.2 (nausea and vomiting) and CPT code 99214 (established patient office visit, level 4) are considered appropriate for this encounter based on the complexity of medical decision making. This documentation supports medical necessity for antiemetic therapy.