Learn about Diabetes with Gastroparesis, also known as Diabetic Gastroparesis or Diabetes-related Gastroparesis. This resource provides information on diagnosis, clinical documentation, and medical coding for healthcare professionals. Find details on ICD-10 codes, symptoms, treatment, and management of Gastroparesis in patients with Diabetes. Improve your understanding of this complex condition and enhance your clinical documentation practices.
Also known as
Diabetes mellitus
Covers various types of diabetes, including type 1 and type 2.
Diseases of stomach/duodenum
Includes other specified diseases of stomach and duodenum.
Symptoms/signs involving abdomen/pelvis
Encompasses abdominal and pelvic symptoms like nausea and vomiting.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the gastroparesis confirmed due to diabetes?
Yes
Type 1 or Type 2 diabetes?
No
Do NOT code as diabetic gastroparesis. Code the underlying cause of gastroparesis and diabetes separately, if present.
When to use each related code
| Description |
|---|
| Diabetes with delayed stomach emptying |
| Slow gastric emptying without diabetes |
| Diabetes without gastroparesis |
Coding requires specifying diabetes type (Type 1, Type 2, etc.) for accurate reimbursement and clinical documentation integrity.
Documentation must clearly link gastroparesis to diabetes. Unspecified etiology can lead to coding errors and denials.
Adequate documentation of related comorbidities (e.g., neuropathy) impacts severity and HCC coding for risk adjustment.
Q: How to differentiate between diabetic gastroparesis and other causes of delayed gastric emptying in patients with diabetes?
A: Diagnosing diabetic gastroparesis requires careful differentiation from other conditions causing delayed gastric emptying, such as functional dyspepsia, peptic ulcer disease, and medication side effects. A thorough clinical evaluation, including a detailed history focusing on diabetes management, symptom onset, and medication use, is crucial. Gastric emptying scintigraphy, the gold standard for diagnosis, confirms delayed gastric emptying in the absence of mechanical obstruction. Consider implementing validated questionnaires like the Gastroparesis Cardinal Symptom Index (GCSI) to assess symptom severity and track treatment response. Explore how combining gastric emptying studies with symptom assessment can enhance diagnostic accuracy in patients with diabetes experiencing upper gastrointestinal symptoms. Further evaluation with upper endoscopy may be warranted to exclude mechanical obstruction or other structural abnormalities. Learn more about the role of prokinetic agents in managing confirmed cases of diabetic gastroparesis.
Q: What are the best evidence-based management strategies for refractory diabetic gastroparesis in a patient with uncontrolled blood glucose?
A: Managing refractory diabetic gastroparesis in patients with uncontrolled blood glucose presents a significant challenge. Optimizing glycemic control is paramount, as hyperglycemia exacerbates gastroparesis symptoms. Intensified insulin therapy, including basal-bolus regimens or continuous subcutaneous insulin infusion, may be necessary. Dietary modifications, including small, frequent meals low in fat and fiber, can improve symptom control. Explore how non-pharmacological interventions, such as gastric electrical stimulation and acupuncture, may provide benefit in selected patients. For refractory symptoms, consider implementing prokinetic agents like metoclopramide or domperidone, while carefully monitoring for potential side effects. Anti-emetics can address nausea and vomiting. Learn more about the emerging role of novel therapies like glinides in managing refractory diabetic gastroparesis and the importance of a multidisciplinary approach involving gastroenterologists, endocrinologists, and registered dietitians.
Patient presents with symptoms consistent with diabetic gastroparesis, a complication of diabetes mellitus. The patient reports delayed gastric emptying manifested by postprandial fullness, nausea, vomiting, early satiety, bloating, and abdominal pain. These symptoms impact the patient's glycemic control and overall quality of life. Assessment includes a detailed history focusing on diabetes management, medication adherence, duration and severity of gastrointestinal symptoms, and dietary habits. Physical examination reveals signs potentially indicative of dehydration and malnutrition. Diagnostic testing may include gastric emptying study, upper endoscopy to rule out other obstructive pathologies, and blood glucose monitoring to assess glycemic control. Differential diagnoses considered include functional dyspepsia, peptic ulcer disease, and intestinal pseudo-obstruction. The patient's current diabetes management regimen was reviewed. Treatment plan focuses on optimizing blood glucose control, dietary modifications including smaller, more frequent meals, low-fat and low-fiber intake, and prokinetic agents such as metoclopramide or erythromycin to accelerate gastric emptying. Patient education emphasizes the importance of diabetes management, medication compliance, and dietary adherence. Follow-up appointments are scheduled to monitor symptom improvement and adjust treatment as needed. ICD-10 code E11.44, Diabetes with gastroparesis, and associated CPT codes for evaluation and management, diagnostic testing, and procedures will be documented. Referral to a gastroenterologist or registered dietitian may be considered for specialized management.