💫 Gastroparesis Coding 101 (Little Uni Style!)
Because even sluggish stomachs deserve swift and sparkly codes
🍽️ What Is Gastroparesis?
Hi coder friend! Little Uni here 🦄✨ galloping in to help you decode a condition that’s more common than folks realize: gastroparesis!
This happens when the stomach muscles move slower than a Monday morning. Food just... hangs out too long in the stomach. And while it’s not a blockage, it is a bummer for the patient.
Symptoms include:
Nausea & vomiting 🤢
Feeling full too soon (even before dessert! 🍰)
Bloating
Belly pain
Unplanned weight loss
💫Now let’s wave our CPT-wand and ICD-scepter, and get to coding it right!
📘 Gastroparesis in ICD-10-CM: The Magical Code
🧾 K31.84 - Gastroparesis
This is your core code when the provider says “gastroparesis” and there’s no deeper cause to chase.
But wait, Little Uni senses a backstory brewing… 🕵️♀️
🔍 Real-Life Scenarios (Cue the Storybook Soundtrack 🎻)
🩺 Gastroparesis + Diabetes
If diabetes is the cause, follow the golden rule: code the diabetes first and the tummy trouble second.
Example (Type 2):
🧠 E11.43 - Type 2 diabetes with autonomic (poly)neuropathy
💫 K31.84 - Gastroparesis
📌 Pro coder tip: Look for the magical linkage words like “diabetic gastroparesis” or “secondary to diabetes.”
🤷♀️ Idiopathic Gastroparesis
When no one's quite sure why it's happening... it's idiopathic!
Keep it simple:
🧾 Just K31.84
No dragons to slay here.
🏥 Post-Surgical Gastroparesis
If a surgery left the stomach sluggish, you might need a combo-code quest!
Example:
🛠️ K91.89 - Postprocedural GI complication
💫 K31.84 - Gastroparesis
🪄 Sometimes it’s just K31.84… Check if the surgeon scribbled a connection in their scroll (aka, op note).
🔄 Gastroparesis + GERD
This duo loves to travel together.
💫 K31.84 - Gastroparesis
🔥 K21.9 - GERD (without esophagitis)
📝 Code both when documented!
🛠️ CPT/Procedure Coding
Gastroparesis may be a diagnosis, but there’s often a whole side quest of diagnostic and treatment codes to go with it!
🔍 Diagnostic Testing (CPT)
91010 – Esophageal motility study (may be done for differential diagnosis)
✨ There is a “code also” note here for 91013 with stimulant or perfusion
91013 – Esophageal motility study; with stimulation or perfusion
✨ “Code also” with 91010 as primary
78264 – Gastric emptying study, solid meal (nuclear medicine scan)
🦄 This one’s super common for confirming gastroparesis!
💉 Treatment-Related (CPT)
Surgical Procedures (Neurostimulators)
43647, 43648, 43881, 43882 - Implantation, revision, or removal of gastric neurostimulator electrodes
64590, 64595 - Insertion/removal of the neurostimulator pulse generator (neurostimulator implant, like a Fitbit for your stomach!)
Electronic Analysis
95980–95982 - Analysis/programming of the neurostim system
Endoscopy Codes
43235 - Upper GI endoscopy (diagnostic)
43236 - Endoscopy with injection (Botox into pyloric sphincter? Yes, that’s a thing!)
43246 - Endoscopy with gastrostomy tube placement
🧃 Feeding & Supportive Care Considerations
Sometimes medication isn't enough, especially when gastroparesis causes long-term nutritional issues. 💙
Coding should reflect the full picture of care. Keep an eye out for:
64590 - Gastric stimulator (✨ dual purpose!)
43246, 49440–49442 - Feeding tube placement or revision
HCPCS B4100–B4162 - Enteral formulas for nutrition
HCPCS B4034–B4088 - Supplies to maintain and deliver feedings
HCPCS B9998 - Miscellaneous enteral supplies (Unicorn code of mystery 🦄)
📌 Tip: These codes often show up in outpatient, DME, or long-term care documentation, so don’t miss them!
📄 Little Uni’s Coding Questions
Ask these and you’ll gallop through gray zones like a pro:
🦄 Is this gastroparesis primary or secondary (caused by something else)?
🦄 Did the provider clearly link it to a condition (like Diabetes) or a procedure?
🦄 Is this an ongoing struggle or an acute (new) flare-up?
🧾 Need to Query? Here’s How:
🗣️ “Can you clarify if gastroparesis is related to diabetes?”
🗣️ “Is this post-surgical or idiopathic gastroparesis?”
Polite. Professional. Powerful. 💌
🌈 Final Thought from Little Uni
You are not just coding gastroparesis. You’re coding quality of life, insurance accuracy, and better outcomes.
🌟 Whether you’re training, auditing, or in the coding trenches, keep your head high and your queries kind.
Gastroparesis may be slow, but you are swift, brilliant, and coding with purpose. Keep asking good questions, querying when things feel fuzzy, and documenting like the rockstar you are. Your work matters more than you know.
Love ❤️this Talia
Thank you you so much as a Gastopresesis patient and advocate and a new coder I could talk on this subject all day . Gastopresesis reflects a minimum of 5 million people here in the United States and while there are few treatments and medication available most do not help and gastopresesis is not curable and very hard to manage. In 2019 we did a walk on Washington to try to get a bill to go thru with our Senators to pass a bill for more studies, better medical coverage and for the FDA to allow certain medications that help treat some of the symptoms. We have a support group with over 50,000 people who talk about their daily struggles. And of course I have my own experiences with Gastopresesis. This coding subject you touched for us today is not a common subject and I am very appreciative you took the time to highlight the coding aspect of it . Thank you .