ICD-10 Coding for Chronic Constipation(K59.04, K59.09)
Complete ICD-10-CM coding and documentation guide for Chronic Constipation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Constipation
K59.0-K59.09Primary Range
Functional intestinal disorders
This range includes codes for various types of constipation, including chronic idiopathic and other specified types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K59.04 | Chronic idiopathic constipation | Use when chronic constipation is present without an identifiable organic cause. |
|
| K59.09 | Other constipation | Use for chronic constipation with specified subtypes like slow transit or outlet dysfunction. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for chronic idiopathic constipation
Essential facts and insights about Chronic Constipation
Primary ICD-10-CM Codes for chronic constipation
Decision Criteria
clinical Criteria
- Symptoms persistent for ≥3 months with no identifiable organic cause.
Applicable To
- Functional constipation
Excludes
- Constipation NOS (K59.00)
Clinical Validation Requirements
- Symptoms persistent for ≥3 months
- Exclusion of secondary causes such as hypothyroidism, diabetes, and medication effects
Code-Specific Risks
- Risk of using unspecified codes if documentation is insufficient
Coding Notes
- Ensure documentation specifies 'chronic idiopathic constipation' to avoid unspecified coding.
K59.09 - Other constipation
Use for chronic constipation with specified subtypes like slow transit or outlet dysfunction.
Applicable To
- Slow transit constipation
- Pelvic floor dyssynergia
Excludes
- Constipation NOS (K59.00)
Clinical Validation Requirements
- Colonic transit study showing >5 retained markers at 120 hours
Coding Notes
Ensure subtype of constipation is documented to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Fecal impaction
K56.41Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Irritable bowel syndrome with constipation
K58.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Constipation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K59.04.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Increases audit risk., Financial: Potential for denied claims.
Mitigation Strategy
Include comprehensive patient history., Document all relevant tests.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces accuracy of patient records.
Mitigation Strategy
Ensure documentation specifies chronicity and subtype of constipation.
Impact
Using unspecified codes due to vague documentation.
Mitigation Strategy
Ensure detailed documentation of chronicity and subtype.
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 Chronic Constipation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Constipation
Use these documentation templates to ensure complete and accurate documentation for Chronic Constipation. These templates include all required elements for proper coding and billing.
Chronic idiopathic constipation diagnosis
Specialty: GastroenterologyRequired Elements
- Symptom duration
- Exclusion of secondary causes
- Bowel movement frequency
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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