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    v1.0.28
    OpenPayerBilling CodesSymptoms and signs involving the digestive system and abdomenICD-10-CM r18-ascites
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    ICD-10-CM Code For Ascites: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group R18 includes codes for ascites and related descriptions of abnormal accumulation of fluid in the peritoneal cavity, covering causes such as liver disease, malignant effusions, and other systemic disorders. These ICD-10-CM diagnosis codes are used to document clinical scenarios where abdominal fluid accumulation affects patient management, captures disease severity, and indicates potential need for diagnostic or therapeutic procedures. Accurate coding within the ICD-10-CM R18 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM R18: Ascites Overview

    The ICD-10-CM R18 group covers ascites, the pathologic accumulation of fluid within the peritoneal cavity, and related clinical presentations. These diagnoses target disorders of the abdominal cavity and often reflect underlying hepatic, cardiac, renal, malignant, or inflammatory disease. Accurate coding matters for reimbursement because it communicates clinical severity and the likely need for procedures such as paracentesis.

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    When to Use

    Use a code from this group when a clinician documents ascites or identifies peritoneal fluid accumulation that impacts care, such as requiring diagnostic evaluation or therapeutic drainage. Select the most specific code available to capture etiology when documented, for example malignant ascites versus unspecified ascites.

    ICD-10-CM Codes

    2 rows

    ICD-10-CM CodeDescription
    R18.0Malignant ascites
    R18.8Other ascites

    DRG Codes

    2 rows

    DRG CodeDescription
    947Signs and Symptoms with MCC
    948Signs and Symptoms without MCC

    Typical Clinical Scenarios

    • An older adult with known cirrhosis presents to the emergency department with increasing abdominal distention, progressive shortness of breath, and discomfort over several days. Physical exam reveals shifting dullness and fluid wave, and bedside ultrasound confirms large-volume free peritoneal fluid; paracentesis is performed for symptom relief and diagnostic analysis. A diagnosis from this group is assigned to document the presence of ascitic fluid as the primary presenting problem. Typical codes: R18.8, R18.0
    • A patient with long-standing metastatic ovarian cancer attends a clinic visit for routine oncology follow-up complaining of gradual abdominal bloating and early satiety; imaging shows moderate-volume ascites without signs of infection. The clinician documents recurrent malignant-related ascites as a chronic complication contributing to nutritional issues and ongoing symptom management. A code from this group is used to capture the ascites as a comorbidity and symptom burden related to the malignancy. Typical codes: R18.8
    • A hospitalized patient with recently diagnosed spontaneous bacterial peritonitis presents with fever, abdominal pain, and increasing abdominal girth; diagnostic paracentesis yields cloudy fluid with positive cultures consistent with infection, and therapeutic drainage is performed. The presence of peritoneal fluid requiring evaluation and intervention is coded from this group to indicate ascites as a complicating clinical finding in the admission. Typical codes: R18.0, R18.8

    Related Codes

    R10-ABDOMINAL-AND-PELVIC-PAIN

    ICD-10-CM Code For Abdominal And Pelvic Pain: Group Overview

    R11-NAUSEA-AND-VOMITING

    ICD-10-CM Code For Nausea And Vomiting: Group Overview

    R12-HEARTBURN

    ICD-10-CM Code For Heartburn: Group Overview

    R13-APHAGIA-AND-DYSPHAGIA

    ICD-10-CM Code For Aphagia And Dysphagia: Group Overview

    R14-FLATULENCE-AND-RELATED-CONDITIONS

    ICD-10-CM Code For Flatulence And Related Conditions: Group Overview

    R15-FECAL-INCONTINENCE

    ICD-10-CM Code For Fecal Incontinence: Group Overview

    R16-HEPATOMEGALY-AND-SPLENOMEGALY

    ICD-10-CM Code For Hepatomegaly And Splenomegaly Not Elsewhere Classified: Group Overview

    R17-UNSPECIFIED-JAUNDICE

    ICD-10-CM Code For Unspecified Jaundice: Group Overview

    R19-OTHER-SYMPTOMS-AND-SIGNS-DIGESTIVE-SYSTEM

    ICD-10-CM Code For Other Symptoms And Signs Involving The Digestive System And Abdomen: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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