ICD-10 Coding for Functional Constipation(K59.04, K59.00)
Complete ICD-10-CM coding and documentation guide for Functional Constipation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Functional Constipation
K59.0-K59.09Primary Range
Other functional intestinal disorders
This range includes codes for functional constipation and related disorders.
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 meets Rome IV criteria and no organic cause is identified. |
|
| K59.00 | Constipation, unspecified | Use when constipation is documented without specific criteria or chronicity. |
|
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 functional constipation
Essential facts and insights about Functional Constipation
Primary ICD-10-CM Codes for functional constipation
Decision Criteria
clinical Criteria
- Rome IV criteria met for chronic constipation
documentation Criteria
- Exclusion of organic causes documented
Applicable To
- Functional constipation
Excludes
- Irritable bowel syndrome with constipation (K58.0)
Clinical Validation Requirements
- Rome IV criteria met for ≥12 weeks
- Exclusion of organic causes
- Documented symptom duration and severity
Code-Specific Risks
- Misclassification with IBS-C
- Inadequate documentation of Rome criteria
Coding Notes
- Ensure documentation clearly supports chronicity and idiopathic nature.
K59.00 - Constipation, unspecified
Use when constipation is documented without specific criteria or chronicity.
Excludes
- Chronic idiopathic constipation (K59.04)
Clinical Validation Requirements
- General constipation symptoms without specific criteria
Coding Notes
Avoid using when specific criteria for chronic idiopathic constipation are met.
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 Functional 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: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Use structured templates, Regular training on documentation standards
Impact
Reimbursement: Potential underpayment due to incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Ensure documentation supports chronic idiopathic constipation before coding K59.04.
Impact
Inadequate documentation can lead to audit failures.
Mitigation Strategy
Ensure comprehensive documentation of all required criteria.
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 Functional Constipation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Functional Constipation
Use these documentation templates to ensure complete and accurate documentation for Functional Constipation. These templates include all required elements for proper coding and billing.
Chronic Functional Constipation in Pediatrics
Specialty: PediatricsRequired Elements
- Symptom duration
- Rome IV criteria
- Exclusion of red flags
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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