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R10.13

Billable

Epigastric pain

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Pain in the upper central area of the abdomen, just below the breastbone where the stomach and esophagus are located.

Coding Tips

  • •Distinguish from chest pain and document if pain is related to eating
  • •Note any associated heartburn, nausea, or vomiting

Excludes 1 — Do NOT code together

  • functional dyspepsia (K30)

Code Hierarchy

└R10Abdominal and pelvic pain└R10.1Pain localized to upper abdomen└R10.13Epigastric pain
└R10.13Epigastric pain

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