# Gastroparesis as primary dx on inpatient claim



## slarimore (Nov 8, 2010)

I recently had a patient that was diagnosed with Gastroparesis. I used this as my principle diagnosis as it was the main thing they were treating. I recieved a call from the Billing supervisor stating that it can not be used as a principle diagnosis. Does anyone have any feedback on why this is not able to be used as the principle diagnosis. In the ICD-9 book it states to "Code first underlying disease, such as: diabetes mellitus (249.6, 250.6)" However this patient does not have diabetes. Can this code be used by itself? Any help is appreciated. Thanks in advance!


----------



## mitchellde (Nov 8, 2010)

No it is not a stand alone code it is a manifestation code.  There needs to be an underlyling causal condition such as but not necessarily diabetes.


----------



## preserene (Nov 8, 2010)

I agree with Mitchellde.

Gastroparesis is defined as delayed gastric emptying, in the absence of mechanical obstruction.
Diabetes, Gerd,gastric pH increase, bacterial toxins, lung transplantation, vagal nerve  injury (as post surgical sequence) and idiopathic; and  medications-like Immunosuppressive drugs,  anticholinergics, narcotics, tricyclic antidepressants, and calcium channel blockers, are known to delay gastric emptying; noticed  even  in patients receiving total parenteral nutrition (TPN ) 
However, the etiology and degree of gastric stasis determine gastric acidity in GASTROPERISIS.
So as Mitchellde said, the patient should have had some underlying pathology; if not documented one such, then place as *idiopathic, after consulting your physician*


----------



## slarimore (Nov 17, 2010)

So if I query the physician and she states that there is no known underlying causal condition how would I code it as idiopathic? Thanks for the assistance!


----------

