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F45.8
ICD-10-CM
Globus Hystericus

Find information on Globus Hystericus, including clinical features, diagnosis, and treatment. This resource covers relevant medical coding terms, ICD-10 codes for Globus Pharyngeus (its current accepted term), and documentation guidelines for healthcare professionals. Learn about the symptoms, differential diagnosis, and management of this functional voice disorder previously known as Globus Hystericus, exploring its connection to psychological factors and somatic symptom disorder. This guide supports accurate clinical documentation and appropriate medical billing practices related to this condition.

Also known as

Globus Sensation
Globus Pharyngeus
Psychogenic Dysphagia

Diagnosis Snapshot

Key Facts
  • Definition : Sensation of a lump or tightness in the throat without physical obstruction.
  • Clinical Signs : Difficulty swallowing, choking sensation, anxiety, feeling of fullness in the throat.
  • Common Settings : Stressful situations, anxiety disorders, history of trauma or abuse.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC F45.8 Coding
F45.8

Other somatoform disorders

Includes globus hystericus, a sensation of a lump in the throat.

R45.0

Symptoms and signs involving appearance and behaviour

Covers abnormalities of sensation and perception, potentially related to globus.

J34.8

Other specified diseases of upper respiratory tract

May be used if physical causes are ruled out and symptoms persist.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Sensation of lump/foreign body in throat?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Sensation of lump in throat
Functional dyspepsia
Somatic symptom disorder

Documentation Best Practices

Documentation Checklist
  • Rule out organic causes: dysphagia, reflux, etc.
  • Document symptom onset, duration, and triggers.
  • Describe sensation: tightness, lump, choking.
  • Note impact on swallowing, breathing, speaking.
  • Psychosocial stressors? Anxiety, depression, trauma?

Coding and Audit Risks

Common Risks
  • Unspecified Diagnosis

    Coding Globus Hystericus without sufficient clinical documentation to support a specific diagnosis can lead to claim denials and inaccurate quality reporting. ICD-10 coding requires specificity.

  • Somatic Symptom Disorder

    Miscoding Globus Hystericus as a solely physical disorder instead of a somatic symptom disorder (F45.8) can impact reimbursement and statistical analysis. CDI specialist review is crucial.

  • Lack of Supporting Documentation

    Insufficient documentation linking the symptoms to Globus Hystericus creates audit risk. Clear documentation of the diagnosis and ruling out other conditions is essential for medical coding compliance.

Mitigation Tips

Best Practices
  • Rule out esophageal dysmotility: ICD-10 R13.1, improve CDI
  • Screen for anxiety/depression: SNOMED CT F32.9, ensure compliance
  • Assess psychosocial stressors: improve documentation for accurate coding
  • Consider CBT/stress management: enhance patient care, optimize coding
  • Collaborate with mental health: ICD-10 F41.9, improve care coordination

Clinical Decision Support

Checklist
  • Rule out esophageal stricture (ICD-10 K22.2)
  • Confirm normal barium swallow study result
  • Assess for psychogenic stressors (e.g., anxiety)
  • Evaluate for other somatic symptoms
  • Consider laryngoscopy to exclude organic causes

Reimbursement and Quality Metrics

Impact Summary
  • Globus Hystericus: Reimbursement and Quality Metrics Impact Summary
  • ICD-10 F45.8, Somatoform disorders: Medical billing, coding accuracy crucial.
  • Impact: Lower reimbursement than organic diagnoses. Coding denials possible.
  • Impact: Psych referral affects LOS, case mix index, hospital reporting.
  • Impact: Patient satisfaction scores may be affected by perceived dismissal.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code F45.8 for Globus Hystericus
  • Document sensation, not diagnosis
  • Rule out physical causes in notes
  • Consider conversion disorder codes
  • Check ICD-10-CM guidelines

Documentation Templates

Patient presents with complaints consistent with globus hystericus, also known as globus pharyngeus or globus sensation.  The patient describes a persistent sensation of a lump or foreign body in the throat, tightness in the throat, or difficulty swallowing, although swallowing studies and physical examination reveal no esophageal obstruction or abnormalities.  Symptoms are intermittent and often worsen with stress or anxiety.  The patient denies dysphagia, odynophagia, or weight loss.  No history of GERD, LPR, or other esophageal pathology.  Differential diagnosis includes esophageal stricture, esophageal web, Zenker's diverticulum, eosinophilic esophagitis, and anxiety disorders.  However, these have been ruled out based on the patient's history, physical examination, and negative diagnostic testing, including a barium swallow study.  The diagnosis of globus hystericus is made based on the characteristic symptoms and exclusion of other organic causes.  Treatment plan includes patient education and reassurance regarding the benign nature of the condition.  Cognitive behavioral therapy (CBT) and stress management techniques will be considered for anxiety management.  Follow-up scheduled in four weeks to reassess symptoms and adjust the treatment plan as needed.  ICD-10 code R45.0 (Symptoms and signs involving the throat and chest) and CPT code 99213 (Office or other outpatient visit for the evaluation and management of an established patient) are appropriate for this encounter.