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20/01/2021

PPI and H2 Antagonist

 

 

 

For Members:

 

  • What is Proton pump inhibitors?

 

Proton pump inhibitors (PPIs) and histamine H2 antagonists (H2 blockers) are the most common medications prescribed for the treatment of gastroesophageal reflux disease (GERD) or peptic ulcer disease (PUD). The treatment usually begins with antacids or over-the-counter H2 blockers for mild symptoms.

 

  • Which is better PPI or h2 blocker?

Both medications work by blocking and decreasing the production of stomach acid, but PPIs are considered stronger and faster in reducing stomach acids. However, H2 receptor blockers specifically decrease the acid released in the evening, which is a common contributor to peptic ulcers.

  • What are the symptoms of too much acid in your stomach?
    • Abdominal discomfort, which may be worse on an empty stomach.
    • nausea or vomiting.
    • bloating.
    • heartburn.
    • diarrhea.
    • decreased appetite.
    • unexplained weight loss.

 

  • How can I reduce my stomach acid naturally?
    • Eat sparingly and slowly. When the stomach is very full, there can be more reflux into the esophagus. It is advised to consume small meals.
    • Avoid certain foods, e.g. Spicy or Oily food
    • Don’t drink carbonated beverages, especially on an empty stomach.
    • Stay up after eating, wait for 2 to 3 hours before lying down.
    • Don’t move too fast or exercise after eating.
    • Sleep on an incline. Use extra pillows or place blocks under the head of your bed to raise it at least 4 inches to 6 inches.
    • Lose weight if it is advised, with diet modification and exercise.
    • If you smoke, quit.
    • Avoid wearing tight clothes or tight belts.
    • Reduce or avoid caffeine intake.

 

 

For Healthcare Providers:

 

Recommendations:

 

  • ICD codes must be coded to the highest level of specificity.
  • Claims for PPI and H2 Antagonist are subject to rejection if non of the below ICDs are used and shall be marked as “Drug is not indicated to the condition/s for which it was prescribed”

 

SPECIFICASS_DESC MNEMONIC ICD SOURCE
041.86 Helicobacter Pylori (H. Pylori) Infection 41.86 041.86 ICD-9
112.84 Candidal Esophagitis 112.84 112.84 ICD-9
251.5 Abnormality Of Secretion Of Gastrin 251.5 251.5 ICD-9
530.10 Esophagitis, Unspecified 530.1 530.10 ICD-9
530.11 Reflux Esophagitis 530.11 530.11 ICD-9
530.12 Acute esophagitis 530.12 530.12 ICD-9
530.13 Eosinophilic esophagitis 530.13 530.13 ICD-9
530.19 Other Esophagitis 530.19 530.19 ICD-9
530.20 Ulcer of esophagus without bleeding 530.2 530.20 ICD-9
530.21 Ulcer of esophagus with bleeding 530.21 530.21 ICD-9
531.00 Acute gastric ulcer with hemorrhage, without mention of obstruction 531 531.00 ICD-9
531.01 Acute gastric ulcer with hemorrhage and obstruction 531.01 531.01 ICD-9
531.10 Acute gastric ulcer with perforation, without mention of obstruction 531.1 531.10 ICD-9
531.11 Acute gastric ulcer with perforation and obstruction 531.11 531.11 ICD-9
531.20 Acute gastric ulcer with hemorrhage and perforation, without mention of obstruction 531.2 531.20 ICD-9
531.21 Acute gastric ulcer with hemorrhage, perforation, and obstruction 531.21 531.21 ICD-9
531.30 Acute gastric ulcer without mention of hemorrhage, perforation, or obstruction 531.3 531.30 ICD-9
531.31 Acute gastric ulcer without mention of hemorrhage or perforation, with obstruction 531.31 531.31 ICD-9
531.40 Chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction 531.4 531.40 ICD-9
531.41 Chronic or unspecified gastric ulcer with hemorrhage and obstruction 531.41 531.41 ICD-9
531.50 Chronic or unspecified gastric ulcer with perforation, without mention of obstruction 531.5 531.50 ICD-9
531.51 Chronic or unspecified gastric ulcer with perforation and obstruction 531.51 531.51 ICD-9
531.60 Chronic or unspecified gastric ulcer with hemorrhage and perforation, without mention of obstruction 531.6 531.60 ICD-9
531.61 Chronic or unspecified gastric ulcer with hemorrhage, perforation, and obstruction 531.61 531.61 ICD-9
531.70 Chronic gastric ulcer without mention of hemorrhage, perforation, without mention of obstruction 531.7 531.70 ICD-9
531.71 Chronic gastric ulcer without mention of hemorrhage or perforation, with obstruction 531.71 531.71 ICD-9
531.90 Gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage, perforation, or obstruction 531.9 531.90 ICD-9
531.91 Gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, with obstruction 531.91 531.91 ICD-9
532.00 Acute duodenal ulcer with hemorrhage, without mention of obstruction 532 532.00 ICD-9
532.01 Acute duodenal ulcer with hemorrhage and obstruction 532.01 532.01 ICD-9
532.10 Acute duodenal ulcer with perforation, without mention of obstruction 532.1 532.10 ICD-9
532.11 Acute duodenal ulcer with perforation and obstruction 532.11 532.11 ICD-9
532.20 Acute duodenal ulcer with hemorrhage and perforation, without mention of obstruction 532.2 532.20 ICD-9
532.21 Acute duodenal ulcer with hemorrhage, perforation, and obstruction 532.21 532.21 ICD-9
532.30 Acute duodenal ulcer without mention of hemorrhage, perforation, or obstruction 532.3 532.30 ICD-9
532.31 Acute duodenal ulcer without mention of hemorrhage or perforation, with obstruction 532.31 532.31 ICD-9
532.40 Chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction 532.4 532.40 ICD-9
532.41 Chronic or unspecified duodenal ulcer with hemorrhage and obstruction 532.41 532.41 ICD-9
532.50 Chronic or unspecified duodenal ulcer with perforation, without mention of obstruction 532.5 532.50 ICD-9
532.51 Chronic or unspecified duodenal ulcer with perforation and obstruction 532.51 532.51 ICD-9
532.60 Chronic or unspecified duodenal ulcer with hemorrhage and perforation, without mention of obstruction 532.6 532.60 ICD-9
532.61 Chronic or unspecified duodenal ulcer with hemorrhage, perforation, and obstruction 532.61 532.61 ICD-9
532.70 Chronic duodenal ulcer without mention of hemorrhage, perforation, or obstruction 532.7 532.70 ICD-9
532.71 Chronic duodenal ulcer without mention of hemorrhage or perforation, with obstruction 532.71 532.71 ICD-9
532.90 Duodenal ulcer, unspecified as acute or chronic, without hemorrhage, perforation, or obstruction 532.9 532.90 ICD-9
532.91 Duodenal ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, with obstruction 532.91 532.91 ICD-9
533.00 Acute peptic ulcer, unspecified site, with hemorrhage, without mention of obstruction 533 533.00 ICD-9
533.01 Acute peptic ulcer, unspecified site, with hemorrhage and obstruction 533.01 533.01 ICD-9
533.10 Acute peptic ulcer, unspecified site, with perforation, without mention of obstruction 533.1 533.10 ICD-9
533.11 Acute peptic ulcer, unspecified site, with perforation and obstruction 533.11 533.11 ICD-9
533.20 Acute peptic ulcer, unspecified site, with hemorrhage and perforation, without mention of obstruction 533.2 533.20 ICD-9
533.21 Acute peptic ulcer, unspecified site, with hemorrhage, perforation, and obstruction 533.21 533.21 ICD-9
533.30 Acute peptic ulcer, unspecified site, without mention of hemorrhage, perforation, or obstruction 533.3 533.30 ICD-9
533.31 Acute peptic ulcer, unspecified site, without mention of hemorrhage and perforation, with obstruction 533.31 533.31 ICD-9
533.40 Chronic or unspecified peptic ulcer, unspecified site, with hemorrhage, without mention of obstruction 533.4 533.40 ICD-9
533.41 Chronic or unspecified peptic ulcer, unspecified site, with hemorrhage and obstruction 533.41 533.41 ICD-9
533.50 Chronic or unspecified peptic ulcer, unspecified site, with perforation, without mention of obstruction 533.5 533.50 ICD-9
533.51 Chronic or unspecified peptic ulcer, unspecified site, with perforation and obstruction 533.51 533.51 ICD-9
533.60 Chronic or unspecified peptic ulcer, unspecified site, with hemorrhage and perforation, without mention of obstruction 533.6 533.60 ICD-9
533.61 Chronic or unspecified peptic ulcer, unspecified site, with hemorrhage, perforation, and obstruction 533.61 533.61 ICD-9
533.70 Chronic peptic ulcer, unspecified site, without mention of hemorrhage, perforation, or obstruction 533.7 533.70 ICD-9
533.71 Chronic peptic ulcer of unspecified site without mention of hemorrhage or perforation, with obstruction 533.71 533.71 ICD-9
533.90 Peptic ulcer, unspecified site, unspecified as acute or chronic, without mention of hemorrhage, perforation, or obstruction 533.9 533.90 ICD-9
533.91 Peptic ulcer, unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, with obstruction 533.91 533.91 ICD-9
534.00 Acute gastrojejunal ulcer with hemorrhage, without mention of obstruction 534 534.00 ICD-9
534.01 Acute gastrojejunal ulcer, with hemorrhage and obstruction 534.01 534.01 ICD-9
534.10 Acute gastrojejunal ulcer with perforation, without mention of obstruction 534.1 534.10 ICD-9
534.11 Acute gastrojejunal ulcer with perforation and obstruction 534.11 534.11 ICD-9
534.20 Acute gastrojejunal ulcer with hemorrhage and perforation, without mention of obstruction 534.2 534.20 ICD-9
534.21 Acute gastrojejunal ulcer with hemorrhage, perforation, and obstruction 534.21 534.21 ICD-9
534.30 Acute gastrojejunal ulcer without mention of hemorrhage, perforation, or obstruction 534.3 534.30 ICD-9
534.31 Acute gastrojejunal ulcer without mention of hemorrhage or perforation, with obstruction 534.31 534.31 ICD-9
534.40 Chronic or unspecified gastrojejunal ulcer with hemorrhage, without mention of obstruction 534.4 534.40 ICD-9
534.41 Chronic or unspecified gastrojejunal ulcer, with hemorrhage and obstruction 534.41 534.41 ICD-9
534.50 Chronic or unspecified gastrojejunal ulcer with perforation, without mention of obstruction 534.5 534.50 ICD-9
534.51 Chronic or unspecified gastrojejunal ulcer with perforation and obstruction 534.51 534.51 ICD-9
534.60 Chronic or unspecified gastrojejunal ulcer with hemorrhage and perforation, without mention of obstruction 534.6 534.60 ICD-9
534.61 Chronic or unspecified gastrojejunal ulcer with hemorrhage, perforation, and obstruction 534.61 534.61 ICD-9
534.70 Chronic gastrojejunal ulcer without mention of hemorrhage, perforation, or obstruction 534.7 534.70 ICD-9
534.71 Chronic gastrojejunal ulcer without mention of hemorrhage or perforation, with obstruction 534.71 534.71 ICD-9
534.90 Gastrojejunal ulcer, unspecified as acute or chronic, without mention of hemorrhage, perforation, or obstruction 534.9 534.90 ICD-9
534.91 Gastrojejunal ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation, with obstruction 534.91 534.91 ICD-9
535.00 Acute gastritis without mention of hemorrhage 535 535.00 ICD-9
535.01 Acute gastritis with hemorrhage 535.01 535.01 ICD-9
535.10 Atrophic gastritis without mention of hemorrhage 535.1 535.10 ICD-9
535.11 Atrophic gastritis with hemorrhage 535.11 535.11 ICD-9
535.20 Gastric mucosal hypertrophy without mention of hemorrhage 535.2 535.20 ICD-9
535.21 Gastric mucosal hypertrophy with hemorrhage 535.21 535.21 ICD-9
535.40 Other specified gastritis without mention of hemorrhage 535.4 535.40 ICD-9
535.41 Other specified gastritis with hemorrhage 535.41 535.41 ICD-9
535.50 Unspecified gastritis and gastroduodenitis without mention of hemorrhage 535.5 535.50 ICD-9
535.51 Unspecified gastritis and gastroduodenitis with hemorrhage 535.51 535.51 ICD-9
535.70 Eosinophilic gastritis, without mention of hemorrhage 535.7 535.70 ICD-9
535.71 Eosinophilic gastritis, with hemorrhage 535.71 535.71 ICD-9
536.8 Dyspepsia And Other Specified Disorders Of Function Of Stomach 536.8 536.8 ICD-9
787.1 Heartburn 787.1 787.1 ICD-9
789.06 Abdominal pain, epigastric 789.06 789.06 ICD-9
789.46 Abdominal rigidity, epigastric 789.46 789.46 ICD-9
789.66 Abdominal tenderness, epigastric 789.66 789.66 ICD-9
B37.81 Candidal esophagitis B37.81 B37.81 ICD-10
B96.81 Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere B96.81 B96.81 ICD-10
E16.4 Increased secretion of gastrin E16.4 E16.4 ICD-10
K20.0 Eosinophilic esophagitis K20.0 K20.0 ICD-10
K20.8 Other esophagitis K20.8 K20.8 ICD-10
K20.9 Esophagitis, unspecified K20.9 K20.9 ICD-10
K21.0 Gastro-esophageal reflux disease with esophagitis K21.0 K21.0 ICD-10
K21.9 Gastro-esophageal reflux disease without esophagitis K21.9 K21.9 ICD-10
K22.10 Ulcer of esophagus without bleeding K22.10 K22.10 ICD-10
K22.11 Ulcer of esophagus with bleeding K22.11 K22.11 ICD-10
K25.0 Acute gastric ulcer with hemorrhage K25.0 K25.0 ICD-10
K25.1 Acute gastric ulcer with perforation K25.1 K25.1 ICD-10
K25.2 Acute gastric ulcer with both hemorrhage and perforation K25.2 K25.2 ICD-10
K25.3 Acute gastric ulcer without hemorrhage or perforation K25.3 K25.3 ICD-10
K25.4 Chronic or unspecified gastric ulcer with hemorrhage K25.4 K25.4 ICD-10
K25.5 Chronic or unspecified gastric ulcer with perforation K25.5 K25.5 ICD-10
K25.6 Chronic or unspecified gastric ulcer with both hemorrhage and perforation K25.6 K25.6 ICD-10
K25.7 Chronic gastric ulcer without hemorrhage or perforation K25.7 K25.7 ICD-10
K25.9 Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation K25.9 K25.9 ICD-10
K26.0 Acute duodenal ulcer with hemorrhage K26.0 K26.0 ICD-10
K26.1 Acute duodenal ulcer with perforation K26.1 K26.1 ICD-10
K26.2 Acute duodenal ulcer with both hemorrhage and perforation K26.2 K26.2 ICD-10
K26.3 Acute duodenal ulcer without hemorrhage or perforation K26.3 K26.3 ICD-10
K26.4 Chronic or unspecified duodenal ulcer with hemorrhage K26.4 K26.4 ICD-10
K26.5 Chronic or unspecified duodenal ulcer with perforation K26.5 K26.5 ICD-10
K26.6 Chronic or unspecified duodenal ulcer with both hemorrhage and perforation K26.6 K26.6 ICD-10
K26.7 Chronic duodenal ulcer without hemorrhage or perforation K26.7 K26.7 ICD-10
K26.9 Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation K26.9 K26.9 ICD-10
K27.0 Acute peptic ulcer, site unspecified, with hemorrhage K27.0 K27.0 ICD-10
K27.1 Acute peptic ulcer, site unspecified, with perforation K27.1 K27.1 ICD-10
K27.2 Acute peptic ulcer, site unspecified, with both hemorrhage and perforation K27.2 K27.2 ICD-10
K27.3 Acute peptic ulcer, site unspecified, without hemorrhage or perforation K27.3 K27.3 ICD-10
K27.4 Chronic or unspecified peptic ulcer, site unspecified, with hemorrhage K27.4 K27.4 ICD-10
K27.5 Chronic or unspecified peptic ulcer, site unspecified, with perforation K27.5 K27.5 ICD-10
K27.6 Chronic or unspecified peptic ulcer, site unspecified, with both hemorrhage and perforation K27.6 K27.6 ICD-10
K27.7 Chronic peptic ulcer, site unspecified, without hemorrhage or perforation K27.7 K27.7 ICD-10
K27.9 Peptic ulcer, site unspecified, unspecified as acute or chronic, without hemorrhage or perforation K27.9 K27.9 ICD-10
K28.0 Acute gastrojejunal ulcer with hemorrhage K28.0 K28.0 ICD-10
K28.1 Acute gastrojejunal ulcer with perforation K28.1 K28.1 ICD-10
K28.2 Acute gastrojejunal ulcer with both hemorrhage and perforation K28.2 K28.2 ICD-10
K28.3 Acute gastrojejunal ulcer without hemorrhage or perforation K28.3 K28.3 ICD-10
K28.4 Chronic or unspecified gastrojejunal ulcer with hemorrhage K28.4 K28.4 ICD-10
K28.5 Chronic or unspecified gastrojejunal ulcer with perforation K28.5 K28.5 ICD-10
K28.6 Chronic or unspecified gastrojejunal ulcer with both hemorrhage and perforation K28.6 K28.6 ICD-10
K28.7 Chronic gastrojejunal ulcer without hemorrhage or perforation K28.7 K28.7 ICD-10
K28.9 Gastrojejunal ulcer, unspecified as acute or chronic, without hemorrhage or perforation K28.9 K28.9 ICD-10
K29.00 Acute gastritis without bleeding K29.00 K29.00 ICD-10
K29.01 Acute gastritis with bleeding K29.01 K29.01 ICD-10
K29.30 Chronic superficial gastritis without bleeding K29.30 K29.30 ICD-10
K29.31 Chronic superficial gastritis with bleeding K29.31 K29.31 ICD-10
K29.40 Chronic atrophic gastritis without bleeding K29.40 K29.40 ICD-10
K29.41 Chronic atrophic gastritis with bleeding K29.41 K29.41 ICD-10
K29.50 Unspecified chronic gastritis without bleeding K29.50 K29.50 ICD-10
K29.51 Unspecified chronic gastritis with bleeding K29.51 K29.51 ICD-10
K29.60 Other gastritis without bleeding K29.60 K29.60 ICD-10
K29.61 Other gastritis with bleeding K29.61 K29.61 ICD-10
K29.70 Gastritis, unspecified, without bleeding K29.70 K29.70 ICD-10
K29.71 Gastritis, unspecified, with bleeding K29.71 K29.71 ICD-10
K30 Functional dyspepsia K30 K30 ICD-10
K52.81 Eosinophilic gastritis or gastroenteritis K52.81 K52.81 ICD-10
R10.13 Epigastric pain R10.13 R10.13 ICD-10
R10.816 Epigastric abdominal tenderness R10.816 R10.816 ICD-10
R10.826 Epigastric rebound abdominal tenderness R10.826 R10.826 ICD-10
R12 Heartburn R12 R12 ICD-10

References: