ICD-10 Coding for Constipation(K59.00, K59.01, K59.02, K59.03, K59.04)
Complete ICD-10-CM coding and documentation guide for Constipation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Constipation
K59.0-K59.09Primary Range
Functional intestinal disorders, not elsewhere classified
This range includes codes specifically for constipation and its variants, such as slow transit, outlet dysfunction, and drug-induced constipation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K59.00 | Constipation, unspecified | Use when no specific type or cause of constipation is documented. |
|
| K59.01 | Slow transit constipation | Use when slow transit is confirmed by diagnostic studies. |
|
| K59.02 | Outlet dysfunction constipation | Use when outlet dysfunction is confirmed by anorectal manometry. |
|
| K59.03 | Drug-induced constipation | Use when constipation is linked to medication use, such as opioids. |
|
| K59.04 | Chronic idiopathic constipation | Use when constipation is chronic and no cause is identified. |
|
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 unspecified constipation
Essential facts and insights about Constipation
Primary ICD-10-CM Codes for constipation
Decision Criteria
documentation Criteria
- No specific type or cause of constipation is documented.
Applicable To
- General constipation without further specification
Clinical Validation Requirements
- Patient reports infrequent bowel movements without specific cause or type documented.
Code-Specific Risks
- Risk of under-coding if specific type or cause is documented elsewhere in the record.
Coding Notes
- Ensure no specific type or cause is documented before using this code.
K59.01 - Slow transit constipation
Use when slow transit is confirmed by diagnostic studies.
Applicable To
- Delayed colonic transit
Clinical Validation Requirements
- Colonic transit study showing >20% markers retained at 5 days.
Coding Notes
Document diagnostic study results to support code use.
K59.02 - Outlet dysfunction constipation
Use when outlet dysfunction is confirmed by anorectal manometry.
Applicable To
- Pelvic floor dyssynergia
Clinical Validation Requirements
- Anorectal manometry showing paradoxical contraction.
Coding Notes
Document manometry results to support code use.
K59.03 - Drug-induced constipation
Use when constipation is linked to medication use, such as opioids.
Applicable To
- Opioid-induced constipation
Clinical Validation Requirements
- Medication list confirming opioid use.
Coding Notes
Document specific drug causing constipation.
K59.04 - Chronic idiopathic constipation
Use when constipation is chronic and no cause is identified.
Applicable To
- Chronic constipation without identifiable cause
Clinical Validation Requirements
- Symptoms >3 months with no structural/physiologic cause.
Coding Notes
Document duration and lack of identifiable cause.
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 Constipation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K59.00.
Impact
Clinical: May lead to inappropriate treatment if drug cause is not identified., Regulatory: Increases risk of audit failure due to incomplete documentation., Financial: Potential loss of reimbursement for drug-related complications.
Mitigation Strategy
Ensure medication review is part of the assessment, Document any temporal relationship between drug use and symptoms
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases data accuracy for clinical research and reporting.
Mitigation Strategy
Review documentation for specific type or cause of constipation.
Impact
Using unspecified codes when more specific codes are available.
Mitigation Strategy
Ensure thorough documentation review to identify specific types or causes.
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 Constipation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Constipation
Use these documentation templates to ensure complete and accurate documentation for Constipation. These templates include all required elements for proper coding and billing.
Chronic constipation management
Specialty: GastroenterologyRequired Elements
- Patient history
- Physical examination findings
- Diagnostic test results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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