Look to Age for Colic Dx
Question: One of our pediatricians saw a 4-month-old patient and reported that the patient is suffering from colic, with symptoms/signs of flatulence and a tight and tender belly. I’m new to working at a pediatric office but thought that “colic” was just a colloquial term for people and a dangerous diagnosis for horses! Should I code this as generalized abdominal pain? Mississippi Subscriber Answer: Before you choose which of these two conditions to report, take note of the patient’s age: The synonym for code R10.83 (Colic) tells you that you should use it for cases of infantile colic. Colic is a pediatric condition affecting patients under 6 months of age that shares symptoms such as flatulence, burping, and a tight belly with abdominal pain. The Excludes1 note for R10.83 then instructs you to code to R10.84 (Generalized abdominal pain) if the colic exists in a patient over 12 months old. Since this patient is 4 months old, R10.83 should be OK. Remember this Excludes1 instruction: While it’s unlikely that a pediatric patient will suffer from renal colic, which occurs when stones form in a patient’s urinary tract, you should bear in mind that N23 (Unspecified renal colic) is listed as an Excludes1 code for all the R10- (Abdominal and pelvic pain) codes. This means you should code N23 if your pediatrician documents stomach pain and this form of colic. Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC
