{"code":"R10.1","type":"code","title":"Pain localized to upper abdomen","codeAlso":[],"includes":[],"modern_v":"official26","codeFirst":[],"excludes1":["renal colic (N23)"],"excludes2":["pain localized to flank (R10.A-)","pelvic and perineal pain (R10.2-)","costovertebral (angle) tenderness (R39.85)","dorsalgia (M54.-)","flatulence and related conditions (R14.-)","congenital or infantile pylorospasm (Q40.0)","gastrointestinal hemorrhage (K92.0-K92.2)","intestinal obstruction (K56.-)","newborn gastrointestinal hemorrhage (P54.0-P54.3)","newborn intestinal obstruction (P76.-)","pylorospasm (K31.3)","signs and symptoms involving the urinary system (R30-R39)","symptoms referable to female genital organs (N94.-)","symptoms referable to male genital organs (N48-N50)"],"isBillable":false,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":false,"billableFy2027":false},"sibling_codes":["R10.10","R10.11","R10.12","R10.13"],"inclusionTerms":[],"sibling_titles":{"code":"R10.13","title":"Epigastric pain","isBillable":true},"useAdditionalCode":[],"clinicalDefinition":"Pain localized to upper abdomen is a non-billable ICD-10-CM category code (R10.1). A more specific billable subcode must be selected for claims submission. Excludes1 (not coded here): renal colic (N23). Excludes2 (not included here): pain localized to flank (R10.A-); pelvic and perineal pain (R10.2-); costovertebral (angle) tenderness (R39.85); dorsalgia (M54.-); flatulence and related conditions (R14.-); congenital or infantile pylorospasm (Q40.0); gastrointestinal hemorrhage (K92.0-K92.","officialDefinition":"Pain localized to upper abdomen is a non-billable ICD-10-CM category code (R10.1). A more specific billable subcode must be selected for claims submission. Excludes1 (not coded here): renal colic (N23). Excludes2 (not included here): pain localized to flank (R10.A-); pelvic and perineal pain (R10.2-); costovertebral (angle) tenderness (R39.85); dorsalgia (M54.-); flatulence and related conditions (R14.-); congenital or infantile pylorospasm (Q40.0); gastrointestinal hemorrhage (K92.0-K92.2); intestinal obstruction (K56.-); newborn gastrointestinal hemorrhage (P54.0-P54.3); newborn intestinal obstruction (P76.-); pylorospasm (K31.3); signs and symptoms involving the urinary system (R30-R39); symptoms referable to female genital organs (N94.-); symptoms referable to male genital organs (N48-N50).","seventhCharacterInstructions":[],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":"","hcc":{"mapped":false,"model":"CMS-HCC V28","paymentYear":"2026","categories":[],"otherModels":[]}}