Functional dyspepsia

This code represents chronic or recurrent upper abdominal pain or discomfort without an identifiable organic cause after thorough diagnostic evaluation. Patients typically experience symptoms such as epigastric pain, burning, postprandial fullness, or early satiety that cannot be attributed to structural disease, metabolic disorders, or other gastrointestinal conditions. It is a diagnosis of exclusion.

Use this code when documentation clearly indicates a diagnosis of functional dyspepsia, often after endoscopy and other investigations have ruled out organic pathology. This code is appropriate for patients presenting with persistent dyspeptic symptoms where no underlying cause has been found. Supporting documentation should detail the diagnostic workup performed to exclude other conditions.

• Ensure all organic causes of dyspepsia have been ruled out before assigning this code.
• Pay close attention to the Excludes1 notes; do not code this with dyspepsia NOS, heartburn, or psychogenic/nervous/neurotic dyspepsia.
• Review provider documentation for specific terminology like "functional dyspepsia" or "non-ulcer dyspepsia" to support code assignment.