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K92.0
ICD-10-CM
Vomiting Blood

Understand vomiting blood (hematemesis) diagnosis, causes, and treatment. Find information on clinical documentation, medical coding (ICD-10), differential diagnosis, and healthcare guidelines for hematemesis. Learn about related symptoms, upper gastrointestinal bleeding, melena, coffee-ground emesis, and endoscopic findings relevant to vomiting blood. Explore resources for healthcare professionals, including best practices for patient care and accurate medical recordkeeping.

Also known as

Hematemeisis
Upper GI Bleed

Diagnosis Snapshot

Key Facts
  • Definition : Vomiting blood (hematemesis) indicates bleeding in the upper digestive tract.
  • Clinical Signs : Bright red blood or coffee-ground vomit, abdominal pain, dizziness, weakness.
  • Common Settings : Emergency room, hospital, GI clinic, endoscopy suite.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC K92.0 Coding
K92.0

Hematemesis

Vomiting of blood, indicating bleeding in the upper digestive tract.

K25-K28

Ulcer of stomach, duodenum

Peptic ulcers can cause bleeding, potentially leading to bloody vomit.

R57.9

Hemorrhage, unspecified

General category for bleeding, including vomiting blood if cause is unknown.

K65-K66

Peritonitis, other inflammations

Severe inflammation in the abdomen can cause bleeding and hematemesis.

Code-Specific Guidance

Decision Tree for

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

Is the vomiting blood due to esophageal varices?

  • Yes

    With bleeding?

  • No

    Is it Mallory-Weiss Tear?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Vomiting blood (hematemesis)
Mallory-Weiss tear
Peptic ulcer disease

Documentation Best Practices

Documentation Checklist
  • Hematemesis documented: onset, frequency, amount, color
  • Melena vs. hematochezia differentiation noted
  • Underlying cause investigation: history, exam, diagnostics
  • Precipitating factors: medications, alcohol, other conditions
  • Associated symptoms: abdominal pain, nausea, lightheadedness

Coding and Audit Risks

Common Risks
  • Unspecified Etiology

    Coding vomiting blood without documenting the cause (e.g., ulcer, Mallory-Weiss) leads to inaccurate DRG assignment and lost revenue.

  • Hematemesis vs. Melena

    Incorrectly coding hematemesis (vomiting blood) as melena (black stool) impacts quality reporting and clinical documentation integrity.

  • Overlooked Comorbidities

    Failing to code associated conditions like esophageal varices or cirrhosis with hematemesis can underestimate patient acuity and complexity.

Mitigation Tips

Best Practices
  • Document hematemesis onset, volume, color for accurate ICD-10 coding (K92.0).
  • CDI: Query physician for cause of vomiting blood (e.g., Mallory-Weiss, ulcer) for specificity.
  • Review labs (CBC, coagulation panel) for anemia, coagulopathy; ensure compliant billing.
  • Endoscopy reporting must detail lesion location, size for appropriate CPT code assignment.
  • Monitor vital signs, fluid status; document interventions for compliant reimbursement (e.g., IV fluids).

Clinical Decision Support

Checklist
  • Confirm hematemesis source (oral, nasal, gastric)
  • Document blood color, volume, and consistency
  • Assess vital signs, including orthostatic changes
  • Order CBC, coagulation profile, liver function tests
  • Consider endoscopy, imaging based on stability

Reimbursement and Quality Metrics

Impact Summary
  • Vomiting Blood (Hematemesis) Reimbursement: Coding accuracy crucial for maximizing payer reimbursements. Optimize ICD-10 (K92.0, K92.2) and CPT codes for procedures like endoscopy (43200-43261). Denials can significantly impact revenue cycle.
  • Quality Metrics Impact: Hematemesis is a high-risk diagnosis. Accurate documentation and coding impact quality metrics related to GI bleed management, hospital-acquired conditions, and patient safety indicators.
  • Severity & Comorbidities: Reimbursement and quality scores influenced by severity (e.g., Mallory-Weiss tear, esophageal varices), comorbidities, and complications. Accurate coding reflects patient complexity.
  • Hospital Reporting: Proper coding of hematemesis is essential for accurate hospital reporting on GI bleed incidence, resource utilization, and outcomes, impacting public health data and quality improvement initiatives.

Streamline Your Medical Coding

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

Quick Tips

Practical Coding Tips
  • Code underlying cause, not just hematemesis
  • Document melena vs hematemesis
  • Specify blood volume if possible
  • Consider Mallory-Weiss, ulcers, varices
  • Check K27 ICD-10-CM guidelines

Documentation Templates

Patient presents with hematemesis, the vomiting of blood, with a chief complaint of (describe color and amount of blood emesis, e.g., bright red blood, coffee-ground emesis approximately 100 mL).  Onset of vomiting blood was (onset time, e.g., two hours prior to arrival).  Associated symptoms include (list associated symptoms, e.g., nausea, abdominal pain, melena, dizziness, syncope, dyspepsia).  Patient denies (list pertinent negatives, e.g., hematochezia, prior episodes of hematemesis, recent NSAID use).  Medical history includes (list relevant medical history, e.g., peptic ulcer disease, esophageal varices, cirrhosis, coagulopathy).  Surgical history includes (list relevant surgical history, e.g., prior gastric surgery, splenectomy).  Current medications include (list current medications, e.g., warfarin, aspirin, NSAIDs).  Family history is significant for (list relevant family history, e.g., bleeding disorders, gastrointestinal cancers).  Physical examination reveals (document vital signs, e.g., blood pressure 8060 mmHg, heart rate 110 bpm, respiratory rate 20 breathsmin; and relevant physical findings, e.g., pallor, abdominal tenderness, melena on rectal exam).  Differential diagnosis includes peptic ulcer bleeding, esophageal varices rupture, Mallory-Weiss tear, gastritis, esophagitis, and malignancy.  Initial diagnostic workup includes complete blood count, coagulation studies, comprehensive metabolic panel, and type and screen.  Treatment plan includes intravenous fluid resuscitation with normal saline, oxygen therapy, and consultation with gastroenterology for esophagogastroduodenoscopy (EGD) to determine the source of bleeding and administer endoscopic therapy if indicated.  Patient condition and treatment response will be closely monitored.  Further management will be based on EGD findings and clinical course.  ICD-10 code K92.0 (Hematemesis) is considered.