ICD-10-CM Codes for Gas and Bloating
For abdominal bloating and gaseous distension, use ICD-10-CM code R14.0 (abdominal distension/bloating), and for flatulence/gas, use R14.3.
Primary Coding Options
R14.0 is the appropriate code for:
- Abdominal bloating (subjective sensation)
- Gaseous distension (objective abdominal girth increase)
- Functional abdominal bloating and distension 1
R14.3 is the appropriate code for:
- Flatulence
- Excessive gas passage
- Eructation (belching) 1
Clinical Context for Code Selection
When bloating occurs as an isolated primary complaint meeting Rome IV criteria (bothersome symptoms for >8 weeks without meeting criteria for IBS, functional constipation, functional diarrhea, or functional dyspepsia), R14.0 is the most appropriate code 1.
When bloating occurs with other functional gastrointestinal disorders (present in >50% of cases), consider additional codes 1:
- K58.x series for irritable bowel syndrome when abdominal pain is related to defecation with altered bowel habits 1
- K59.00 for functional constipation when constipation predominates 2
- K30 for functional dyspepsia when upper abdominal pain/discomfort unrelated to defecation is the primary complaint 1
Important Coding Considerations
Do not use R14.0 if the patient meets full diagnostic criteria for another functional disorder where bloating is merely a secondary symptom. The Rome IV criteria specifically state that functional abdominal bloating/distension should not be diagnosed when criteria for IBS, functional constipation, functional diarrhea, or functional dyspepsia are met 1.
Consider organic causes requiring different codes before defaulting to functional codes 2, 3:
- Celiac disease requires K90.0 if tissue transglutaminase IgA is positive with confirmatory biopsy 3, 4
- Small intestinal bacterial overgrowth (SIBO) may warrant K90.89 (other intestinal malabsorption) 4
- Lactose intolerance requires E73.x series 1, 4
Alarm features necessitate investigation before coding as functional 2, 3:
- Weight loss >10% requires workup for malabsorption, IBD, or malignancy before using functional codes 3
- GI bleeding, anemia, or nocturnal symptoms exclude functional disorders 3
- Age >40-45 years may require endoscopy to exclude organic pathology before functional diagnosis 1, 3
Common Pitfalls
Avoid coding bloating as IBS (K58.x) when abdominal pain is not related to defecation. In functional dyspepsia, pain is epigastric and unrelated to bowel movements, whereas IBS pain is relieved or worsened by defecation 1.
Do not use R14.0 for aerophagia or supragastric belching, which have distinct pathophysiology involving air swallowing and require R14.3 or more specific codes based on manometry findings 1.
Recognize that up to 50% of patients have overlapping conditions requiring multiple codes when both bloating and another functional disorder independently meet diagnostic criteria 1.