Understanding Emesis: Find information on vomiting, nausea and vomiting, and the diagnosis of emesis. This resource covers clinical documentation, medical coding, healthcare best practices, and differential diagnosis related to emesis for medical professionals. Learn about the causes, treatment, and management of emesis in a clinical setting.
Also known as
Nausea and vomiting
Symptoms of nausea and vomiting, unspecified cause.
Nausea alone
Nausea without vomiting.
Vomiting NOS
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the emesis due to a drug or other external cause?
When to use each related code
| Description |
|---|
| Vomiting or nausea and vomiting. |
| Nausea without vomiting. |
| Indigestion or dyspepsia. |
Coding Emesis without specifying cause (e.g., chemotherapy, pregnancy) can lead to rejected claims and lower reimbursement.
Incorrectly coding Nausea (R11) instead of Vomiting (R11.1) or vice-versa affects clinical documentation integrity and data accuracy.
Coding Emesis as the principal diagnosis when it's a symptom of another condition can trigger audits and compliance issues.
Q: What are the key differential diagnoses to consider when a patient presents with acute onset emesis in the emergency department?
A: Acute onset emesis in the emergency department can be caused by a wide range of conditions, requiring a thorough differential diagnosis process. Gastrointestinal causes like gastroenteritis, appendicitis, bowel obstruction, and pancreatitis should be high on the list. Consider also non-GI causes such as migraine, myocardial infarction, medication side effects (e.g., chemotherapy), and even neurological conditions like brain tumors or increased intracranial pressure. Infectious etiologies like sepsis and meningitis must also be ruled out. Patient history, physical examination findings, and targeted laboratory tests are crucial for narrowing down the possibilities and guiding appropriate management. Explore how a systematic approach can enhance diagnostic accuracy in acute emesis cases.
Q: How can I differentiate between central and peripheral causes of emesis in a pediatric patient, and what specific red flags warrant immediate further investigation?
A: Differentiating between central (neurological) and peripheral (GI) causes of emesis in children requires careful evaluation. Central causes, such as migraines, meningitis, or posterior fossa tumors, often present with associated neurological symptoms like headache, altered mental status, or ataxia. Peripheral causes like gastroenteritis, infections, or metabolic disturbances typically manifest with GI symptoms like diarrhea, abdominal pain, or fever. Red flags necessitating immediate further investigation include bilious vomiting, projectile vomiting, altered consciousness, focal neurological deficits, and signs of dehydration or sepsis. In any case of uncertainty, consider performing a thorough neurological assessment and ordering appropriate imaging studies like head CT or MRI. Learn more about the specific diagnostic tests recommended for evaluating pediatric emesis.
Patient presents with emesis, also documented as vomiting, or nausea and vomiting. Onset of symptoms was [Date/Time]. The patient reports [frequency] episodes of vomiting with [description of vomitus - e.g., undigested food, bile, coffee-ground appearance, hematemesis]. Associated symptoms include [list associated symptoms, e.g., nausea, abdominal pain, diarrhea, fever, dizziness, lightheadedness, dehydration]. The patient denies [list pertinent negatives, e.g., hematochezia, melena, recent head injury, pregnancy]. Differential diagnosis includes gastroenteritis, food poisoning, gastroparesis, intestinal obstruction, migraine, medication side effects, and cyclic vomiting syndrome. Physical examination reveals [relevant findings, e.g., abdominal tenderness, hyperactive or hypoactive bowel sounds, dry mucous membranes, tachycardia, orthostatic hypotension]. Patient's vital signs are [Temperature, Heart rate, Respiratory rate, Blood pressure]. Assessment indicates [Severity - e.g., mild, moderate, severe] dehydration. Plan includes [Diagnostic testing if indicated - e.g., complete blood count, metabolic panel, urinalysis, abdominal imaging], administration of [Medications - e.g., antiemetics, IV fluids], and monitoring of fluid intake and output. Patient education provided on dietary modifications, including clear liquids and the BRAT diet (bananas, rice, applesauce, and toast), and signs and symptoms of dehydration. Follow-up scheduled for [Date/Time] to assess symptom resolution and hydration status. ICD-10 code [appropriate ICD-10 code, e.g., R11.10 for nausea and vomiting, unspecified] considered for medical billing and coding purposes.