Appendicitis

• Severity (acute, chronic, recurrent, relapsing, subacute)
• Is peritonitis (localized or general) or a peritoneal abscess present?
• Does the patient have gangrene or a perforation?

Ascities

Document if ascites is malignant. If ascites is malignant, link the ascites to the neoplasm.

Fecal impaction

Gastroenteritis

• Infectious (organism known or suspected)
• Non-infectious (radiation, drug-induced, allergy or food hypersensitivity) - specify drug or food when known

Ileus

Small bowel obstruction

Pancreatitis

• Acute versus chronic
• Etiology with cause and effect. For example:
• Idiopathic acute pancreatitis
• Alcohol-induced acute pancreatitis
• Gallstone or biliary pancreatitis
• Drug-induced pancreatitis

Pelvic Inflammatory Disease

Peptic ulcer disease

• Acute versus chronic
• Site (duodenal, esophagus, gastric, other)
• Underlying cause (alcohol, drug or chemical)
• Associated signs and symptoms (perforation, hemorrhage, perforation and hemorrhage)

Peritonitis

Adult (main)|Emergency room(main)|Pediatrics (main)

Thanks to Advocate's Clinical Documentation Improvement and Coding teams for their assistance with this content.

Please enter your comments below for us to update this information based on your feedback.