ICD-10 Coding for Irritable Bowel Syndrome with Constipation(K58.1)
Complete ICD-10-CM coding and documentation guide for Irritable Bowel Syndrome with Constipation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Irritable Bowel Syndrome with Constipation
K58-K59Primary Range
Functional intestinal disorders
This range includes codes for irritable bowel syndrome and other functional bowel disorders, specifically covering IBS with constipation.
Key Information: ICD-10 code for IBS with constipation
Essential facts and insights about Irritable Bowel Syndrome with Constipation
Primary ICD-10-CM Code for irritable bowel syndrome constipation
Decision Criteria
clinical Criteria
- Abdominal pain at least 1 day per week for 3 months
documentation Criteria
- Document Rome IV criteria and normal lab results
Applicable To
- IBS with constipation
Excludes
- IBS with diarrhea (K58.0)
Clinical Validation Requirements
- Recurrent abdominal pain at least 1 day per week
- Constipation-predominant stools in at least 25% of bowel movements
- Symptoms meet Rome IV criteria
Code-Specific Risks
- Misclassification if Rome IV criteria are not met
- Omission of exclusionary testing documentation
Coding Notes
- Ensure documentation of Rome IV criteria and exclusion of other conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Irritable Bowel Syndrome with Constipation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K58.1.
Impact
Clinical: May lead to misdiagnosis and inappropriate treatment., Regulatory: Increases risk of audit and compliance issues., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Include normal lab and imaging results in documentation, Use structured templates to ensure completeness
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use K58.1 for IBS-C with documented criteria instead of unspecified codes.
Impact
Failure to document criteria can lead to audits.
Mitigation Strategy
Use structured templates and checklists to ensure all criteria are documented.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Irritable Bowel Syndrome with Constipation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irritable Bowel Syndrome with Constipation
Use these documentation templates to ensure complete and accurate documentation for Irritable Bowel Syndrome with Constipation. These templates include all required elements for proper coding and billing.
Gastroenterology Progress Note
Specialty: GastroenterologyRequired Elements
- Patient history
- Symptom frequency and duration
- Rome IV criteria
- Lab and imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Irritable Bowel Syndrome with Constipation? Ask your questions below.