ICD-10 · PDGM grouping
R10-R19 — Symptoms and signs involving the digestive system and abdomen
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in range
99
No clinical group
93
A period cannot be grouped from these.
Barred as primary
1
CMS rejects these in the primary position.
Where these codes group
6 of the 99 codes in R10-R19 group to Neuro Rehabilitation. A further 93 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in R10-R19
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
- R10Abdominal and pelvic pain42 codes
- R11Nausea and vomiting9 codes
- R12Heartburn1 code
- R13Aphagia and dysphagia7 codes
- R14Flatulence and related conditions4 codes
- R15Fecal incontinence4 codes
- R16Hepatomegaly and splenomegaly, not elsewhere classified3 codes
- R17Unspecified jaundice1 code
- R18Ascites2 codes
- R19Other symptoms and signs involving the digestive system and abdomen26 codes
Every code in R10-R19
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| R100 | Acute abdomen | None | Cannot lead a claim |
| R1010 | Upper abdominal pain, unspecified | None | Cannot lead a claim |
| R1011 | Right upper quadrant pain | None | Cannot lead a claim |
| R1012 | Left upper quadrant pain | None | Cannot lead a claim |
| R1013 | Epigastric pain | None | Cannot lead a claim |
| R1020 | Pelvic and perineal pain unspecified side | None | Cannot lead a claim |
| R1021 | Pelvic and perineal pain right side | None | Cannot lead a claim |
| R1022 | Pelvic and perineal pain left side | None | Cannot lead a claim |
| R1023 | Pelvic and perineal pain bilateral | None | Cannot lead a claim |
| R1024 | Suprapubic pain | None | Cannot lead a claim |
| R1030 | Lower abdominal pain, unspecified | None | Cannot lead a claim |
| R1031 | Right lower quadrant pain | None | Cannot lead a claim |
| R1032 | Left lower quadrant pain | None | Cannot lead a claim |
| R1033 | Periumbilical pain | None | Cannot lead a claim |
| R10811 | Right upper quadrant abdominal tenderness | None | Cannot lead a claim |
| R10812 | Left upper quadrant abdominal tenderness | None | Cannot lead a claim |
| R10813 | Right lower quadrant abdominal tenderness | None | Cannot lead a claim |
| R10814 | Left lower quadrant abdominal tenderness | None | Cannot lead a claim |
| R10815 | Periumbilic abdominal tenderness | None | Cannot lead a claim |
| R10816 | Epigastric abdominal tenderness | None | Cannot lead a claim |
| R10817 | Generalized abdominal tenderness | None | Cannot lead a claim |
| R10819 | Abdominal tenderness, unspecified site | None | Cannot lead a claim |
| R10821 | Right upper quadrant rebound abdominal tenderness | None | Cannot lead a claim |
| R10822 | Left upper quadrant rebound abdominal tenderness | None | Cannot lead a claim |
| R10823 | Right lower quadrant rebound abdominal tenderness | None | Cannot lead a claim |
| R10824 | Left lower quadrant rebound abdominal tenderness | None | Cannot lead a claim |
| R10825 | Periumbilic rebound abdominal tenderness | None | Cannot lead a claim |
| R10826 | Epigastric rebound abdominal tenderness | None | Cannot lead a claim |
| R10827 | Generalized rebound abdominal tenderness | None | Cannot lead a claim |
| R10829 | Rebound abdominal tenderness, unspecified site | None | Cannot lead a claim |
| R1083 | Colic | None | Cannot lead a claim |
| R1084 | Generalized abdominal pain | None | Cannot lead a claim |
| R1085 | Abdominal pain of multiple sites | None | Cannot lead a claim |
| R108A1 | Right flank tenderness | None | Cannot lead a claim |
| R108A2 | Left flank tenderness | None | Cannot lead a claim |
| R108A3 | Suprapubic tenderness | None | Cannot lead a claim |
| R108A9 | Flank tenderness, unspecified | None | Cannot lead a claim |
| R109 | Unspecified abdominal pain | None | Cannot lead a claim |
| R10A0 | Flank pain, unspecified side | None | Cannot lead a claim |
| R10A1 | Flank pain, right side | None | Cannot lead a claim |
| R10A2 | Flank pain, left side | None | Cannot lead a claim |
| R10A3 | Flank pain, bilateral | None | Cannot lead a claim |
| R110 | Nausea | None | Cannot lead a claim |
| R1110 | Vomiting, unspecified | None | Cannot lead a claim |
| R1111 | Vomiting without nausea | None | Cannot lead a claim |
| R1112 | Projectile vomiting | None | Cannot lead a claim |
| R1113 | Vomiting of fecal matter | None | Cannot lead a claim |
| R1114 | Bilious vomiting | None | Cannot lead a claim |
| R1115 | Cyclical vomiting syndrome unrelated to migraine | None | Cannot lead a claim |
| R1116 | Cannabis hyperemesis syndrome | None | Cannot lead a claim |
| R112 | Nausea with vomiting, unspecified | None | Cannot lead a claim |
| R12 | Heartburn | None | Cannot lead a claim |
| R130 | Aphagia | None | Cannot lead a claim |
| R1310 | Dysphagia, unspecified | B | Can lead a claim, code first applies |
| R1311 | Dysphagia, oral phase | B | Can lead a claim, code first applies |
| R1312 | Dysphagia, oropharyngeal phase | B | Can lead a claim, code first applies |
| R1313 | Dysphagia, pharyngeal phase | B | Can lead a claim, code first applies |
| R1314 | Dysphagia, pharyngoesophageal phase | B | Can lead a claim, code first applies |
| R1319 | Other dysphagia | B | Can lead a claim, code first applies |
| R140 | Abdominal distension (gaseous) | None | Cannot lead a claim |
| R141 | Gas pain | None | Cannot lead a claim |
| R142 | Eructation | None | Cannot lead a claim |
| R143 | Flatulence | None | Cannot lead a claim |
| R150 | Incomplete defecation | None | Cannot lead a claim |
| R151 | Fecal smearing | None | Cannot lead a claim |
| R152 | Fecal urgency | None | Cannot lead a claim |
| R159 | Full incontinence of feces | None | Cannot lead a claim |
| R160 | Hepatomegaly, not elsewhere classified | None | Cannot lead a claim |
| R161 | Splenomegaly, not elsewhere classified | None | Cannot lead a claim |
| R162 | Hepatomegaly with splenomegaly, not elsewhere classified | None | Cannot lead a claim |
| R17 | Unspecified jaundice | None | Cannot lead a claim |
| R180 | Malignant ascites | None | Cannot lead a claim |
| R188 | Other ascites | None | Cannot lead a claim |
| R1900 | Intra-abd and pelvic swelling, mass and lump, unsp site | None | Cannot lead a claim |
| R1901 | Right upper quadrant abdominal swelling, mass and lump | None | Cannot lead a claim |
| R1902 | Left upper quadrant abdominal swelling, mass and lump | None | Cannot lead a claim |
| R1903 | Right lower quadrant abdominal swelling, mass and lump | None | Cannot lead a claim |
| R1904 | Left lower quadrant abdominal swelling, mass and lump | None | Cannot lead a claim |
| R1905 | Periumbilic swelling, mass or lump | None | Cannot lead a claim |
| R1906 | Epigastric swelling, mass or lump | None | Cannot lead a claim |
| R1907 | Generalized intra-abd and pelvic swelling, mass and lump | None | Cannot lead a claim |
| R1909 | Other intra-abdominal and pelvic swelling, mass and lump | None | Cannot lead a claim |
| R1911 | Absent bowel sounds | None | Cannot lead a claim |
| R1912 | Hyperactive bowel sounds | None | Cannot lead a claim |
| R1915 | Other abnormal bowel sounds | None | Cannot lead a claim |
| R192 | Visible peristalsis | None | Cannot lead a claim |
| R1930 | Abdominal rigidity, unspecified site | None | Cannot lead a claim |
| R1931 | Right upper quadrant abdominal rigidity | None | Cannot lead a claim |
| R1932 | Left upper quadrant abdominal rigidity | None | Cannot lead a claim |
| R1933 | Right lower quadrant abdominal rigidity | None | Cannot lead a claim |
| R1934 | Left lower quadrant abdominal rigidity | None | Cannot lead a claim |
| R1935 | Periumbilic abdominal rigidity | None | Cannot lead a claim |
| R1936 | Epigastric abdominal rigidity | None | Cannot lead a claim |
| R1937 | Generalized abdominal rigidity | None | Cannot lead a claim |
| R194 | Change in bowel habit | None | Cannot lead a claim |
| R195 | Other fecal abnormalities | None | Cannot lead a claim |
| R196 | Halitosis | None | Cannot lead a claim |
| R197 | Diarrhea, unspecified | None | Cannot lead a claim |
| R198 | Oth symptoms and signs involving the dgstv sys and abdomen | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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