Find information on indigestion diagnosis, including dyspepsia, functional dyspepsia, epigastric pain, bloating, nausea, and early satiety. Learn about associated ICD-10 codes (K30, R12), SNOMED CT concepts, differential diagnoses, and best practices for clinical documentation to support accurate medical coding and billing for healthcare professionals. Explore resources for patient education and management of indigestion symptoms.
Also known as
Functional dyspepsia
Covers indigestion, heartburn, and other stomach discomfort without a clear cause.
Symptoms/signs involving abdomen/pelvis
Includes general abdominal pain, nausea, and vomiting that might accompany indigestion.
Gastritis and duodenitis
Inflammation of stomach/duodenum, a potential underlying cause of indigestion.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the indigestion associated with vomiting?
Yes
Is vomiting predominant?
No
Is there heartburn or acid regurgitation?
When to use each related code
| Description |
|---|
| Indigestion (Dyspepsia) |
| Gastroesophageal Reflux Disease (GERD) |
| Peptic Ulcer Disease (PUD) |
Using R12 (Indigestion, unspecified) when a more specific diagnosis code is documented, leading to inaccurate severity reflection and reimbursement.
Miscoding GERD (gastroesophageal reflux disease) symptoms as indigestion (R12) when GERD is the actual underlying diagnosis, impacting quality metrics.
Incorrectly coding functional dyspepsia (K30) as unspecified indigestion (R12), affecting clinical documentation improvement (CDI) efforts and data accuracy.
Q: What are the most effective differential diagnosis strategies for persistent indigestion in adult patients, considering both common and less common causes?
A: Differential diagnosis of persistent indigestion (dyspepsia) requires a systematic approach to distinguish between functional dyspepsia, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and less common etiologies like gastroparesis, pancreatic insufficiency, or even coronary artery disease. Start by obtaining a thorough history, including symptom duration, character (e.g., burning, bloating, early satiety), medication use (NSAIDs, aspirin), and alarm symptoms (weight loss, dysphagia, GI bleeding). Physical exam should focus on abdominal tenderness, signs of anemia, or cardiovascular abnormalities. Initial investigations might include upper endoscopy for patients over 55 or with alarm symptoms, H. pylori testing, and possibly gastric emptying studies if gastroparesis is suspected. Consider implementing Rome IV criteria for diagnosing functional dyspepsia if organic causes are ruled out. Explore how to tailor diagnostic testing based on individual patient presentation and risk factors for optimal patient care. For patients with refractory dyspepsia, consider referral to a gastroenterologist. Learn more about the latest guidelines for managing refractory functional dyspepsia.
Q: How can I differentiate between functional dyspepsia and GERD in a patient presenting with overlapping indigestion symptoms like epigastric pain and bloating, and what are the best management strategies for each?
A: Differentiating functional dyspepsia and GERD can be challenging due to overlapping symptoms. Focus on symptom characteristics: functional dyspepsia often presents with postprandial fullness, early satiety, and epigastric pain or burning, while GERD typically involves heartburn, regurgitation, and acid reflux. A trial of proton pump inhibitors (PPIs) can be diagnostic and therapeutic for GERD; symptom improvement suggests GERD, while persistent symptoms despite adequate PPI therapy may point to functional dyspepsia. Consider implementing Rome IV criteria for diagnosing functional dyspepsia after excluding organic diseases. Management strategies differ: GERD focuses on acid suppression with PPIs, lifestyle modifications (e.g., avoiding trigger foods, elevating the head of the bed), and prokinetic agents if needed. Functional dyspepsia management includes dietary adjustments, stress management techniques, prokinetics, and possibly low-dose tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) in select cases. Explore how to combine pharmacological and non-pharmacological approaches for personalized patient care. Learn more about the role of psychological factors in functional dyspepsia and how to address them.
Patient presents with complaints consistent with indigestion, also known as dyspepsia or functional dyspepsia. Symptoms include postprandial fullness, early satiety, epigastric pain, epigastric burning, and abdominal discomfort. Patient denies heartburn, regurgitation, nausea, vomiting, or dysphagia. Onset of symptoms occurred approximately [timeframe] ago and is [frequency] in nature. Patient reports aggravating factors such as [list aggravating factors, e.g., greasy foods, large meals, caffeine] and alleviating factors such as [list alleviating factors, e.g., antacids, avoiding trigger foods]. Review of systems negative for significant findings. Past medical history includes [list relevant medical history]. Medications include [list current medications]. Family history is noncontributory. Physical examination reveals normal bowel sounds, no abdominal tenderness or distension. Vitals stable. Assessment: Indigestion (ICD-10: K30). Differential diagnoses considered include gastroesophageal reflux disease (GERD), peptic ulcer disease, gastritis, and cholelithiasis. Plan: Patient education provided on dietary modifications, including avoiding trigger foods and smaller, more frequent meals. Recommended over-the-counter antacids as needed. If symptoms persist or worsen, further evaluation with upper endoscopy andor H. pylori testing may be considered. Follow-up scheduled in [timeframe] to assess symptom improvement. Counseling provided on lifestyle modifications including stress management and regular exercise. Patient verbalized understanding of the plan.