ICD-10 Coding for Irritable Bowel Syndrome(K58.0, K58.1, K58.2, K58.9)
Complete ICD-10-CM coding and documentation guide for Irritable Bowel Syndrome. 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
K58Primary Range
Irritable bowel syndrome
This range includes all subtypes of IBS, which are categorized based on predominant symptoms such as diarrhea, constipation, or mixed.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K58.0 | Irritable bowel syndrome with diarrhea | Use when diarrhea predominates in IBS symptoms. |
|
| K58.1 | Irritable bowel syndrome with constipation | Use when constipation predominates in IBS symptoms. |
|
| K58.2 | Mixed irritable bowel syndrome | Use when both diarrhea and constipation are present in IBS symptoms. |
|
| K58.9 | Irritable bowel syndrome, unspecified | Use when the subtype of IBS is not specified in the documentation. |
|
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 IBS with diarrhea
Essential facts and insights about Irritable Bowel Syndrome
Primary ICD-10-CM Codes for irritable bowel syndrome
Decision Criteria
clinical Criteria
- Diarrhea predominates in stool pattern.
documentation Criteria
- Rome IV criteria are met and documented.
Applicable To
- IBS-D
Excludes
- Functional diarrhea (K59.1)
Clinical Validation Requirements
- Rome IV criteria: Abdominal pain related to defecation, change in stool frequency or form
- Predominant diarrhea: >25% of bowel movements are Bristol Type 6-7
Code-Specific Risks
- Incorrectly coding as unspecified IBS when diarrhea is documented.
Coding Notes
- Ensure documentation specifies diarrhea predominance to avoid defaulting to unspecified IBS.
K58.1 - Irritable bowel syndrome with constipation
Use when constipation predominates in IBS symptoms.
Applicable To
- IBS-C
Excludes
- Functional constipation (K59.0)
Clinical Validation Requirements
- Rome IV criteria: Abdominal pain related to defecation, change in stool frequency or form
- Predominant constipation: >25% of bowel movements are Bristol Type 1-2
Coding Notes
Ensure documentation specifies constipation predominance to avoid defaulting to unspecified IBS.
K58.2 - Mixed irritable bowel syndrome
Use when both diarrhea and constipation are present in IBS symptoms.
Applicable To
- IBS-M
Clinical Validation Requirements
- Rome IV criteria: Abdominal pain related to defecation, change in stool frequency or form
- Alternating diarrhea and constipation meeting subtype thresholds
Coding Notes
Ensure documentation specifies mixed symptomatology to avoid defaulting to unspecified IBS.
K58.9 - Irritable bowel syndrome, unspecified
Use when the subtype of IBS is not specified in the documentation.
Applicable To
- IBS without specified subtype
Clinical Validation Requirements
- Rome IV criteria: Abdominal pain related to defecation, change in stool frequency or form
Coding Notes
Use only when subtype is not documented.
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 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K58.0.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential reimbursement issues.
Mitigation Strategy
Use structured templates, Educate providers on documentation standards
Impact
Reimbursement: May lead to incorrect DRG assignment affecting reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health data.
Mitigation Strategy
Ensure documentation specifies the subtype and use the corresponding code.
Impact
Failure to document IBS subtype can lead to audit issues.
Mitigation Strategy
Ensure all documentation includes specific subtype details.
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 expert answers to help guide accurate code selection and documentation.
Documentation Templates for Irritable Bowel Syndrome
Use these documentation templates to ensure complete and accurate documentation for Irritable Bowel Syndrome. These templates include all required elements for proper coding and billing.
IBS with predominant diarrhea
Specialty: GastroenterologyRequired Elements
- Rome IV criteria
- Stool pattern
- Pain characteristics
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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