Pain Management Coding Alert

You Be the Coder:

Remember, Different Types of Ab Pain Have Different Codes

Question: What is the correct ICD-10 code for upper-quadrant abdominal pain?

Indiana Subscriber

Answer: It depends on the exact location and type of the abdominal pain. ICD-10 goes deep to provide you with four different codes for the type of pain you describe. Go back and check the encounter notes, and then choose one of the following ICD-10 codes to best represent the patient's pain:

  • R10.10 - Upper abdominal pain, unspecified
  • R10.11 - Right upper quadrant pain
  • R10.12 - Left upper quadrant pain
  • R10.13 - Epigastric pain.

Remember: The above diagnosis codes are for abdominal pain specifically - but not for when the provider diagnoses abdominal tenderness. According to Howard J. Bennett, physician and blogger, this is the difference between tenderness and pain: "If something is painful, that means it hurts [almost all the time]. If something is tender, that means it hurts when it is touched or moved," he writes. If the provider specifies upper quadrant abdominal tenderness rather than pain, you'll most likely choose from the following codes:

  • R10.811 - Right upper quadrant abdominal tenderness
  • R10.812 - Left upper quadrant abdominal tenderness
  • R10.815 - Periumbilic abdominal tenderness
  • R10.816 - Epigastric abdominal tenderness
  • R10.817 - Generalized abdominal tenderness
  • R10.819 - Abdominal tenderness, unspecified site.

One more: If the provider specifies rebound abdominal tenderness, you'll choose from a different set of codes. According to, rebound abdominal tenderness a condition "in which the pain is worse after a quick release of deeper palpation pressure. This is called Blumberg's sign."

If the provider specifies upper quadrant rebound abdominal tenderness, you'll most likely choose from the following codes:

  • R10.821 - Right upper quadrant rebound abdominal tenderness
  • R10.822 - Left upper quadrant rebound abdominal tenderness
  • R10.825 - Periumbilic rebound abdominal tenderness
  • R10.826 - Epigastric rebound abdominal tenderness
  • R10.827 - Generalized rebound abdominal tenderness
  • R10.829 - Rebound abdominal tenderness, unspecified site.

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