ICD-10-CM work item

EasyFY 2027Synthetic · Educational use only

Digestive Symptom Evaluation

Code from chart · WRK-018

Clinical chart
Signed note

Signed encounter note

DOS · 2026-10-27Assignment · WRK-018Setting · Outpatient physician office

Reason for visit

Evaluation of nausea.

Interval history

Nausea began two days ago without vomiting. The patient is able to tolerate fluids and reports no fever or focal abdominal pain.

Examination

The abdomen is soft and nontender without guarding; hydration appears adequate.

Assessment and plan

Nausea without vomiting; etiology remains undetermined. Provide supportive care and return precautions for worsening symptoms or new vomiting.