ICD Code K58.1

ICD code K58.1 is irritable bowel syndrome with constipation, a condition where a person experiences abdominal discomfort or pain along with infrequent or difficult bowel movements.

1. Recurrent abdominal pain or discomfort occurring at least one day per week in the last three months

2. Abdominal pain or discomfort associated with two or more of the following:

a. Improvement with defecation

b. Onset associated with a change in frequency of stool

c. Onset associated with a change in form (appearance) of stool

3. Predominant stool pattern characterized by hard or lumpy stools in more than 25% of bowel movements and loose or watery stools in less than 25% of bowel movements

4. Symptoms present for at least six months prior to diagnosis

5. Absence of alarm features such as gastrointestinal bleeding, unexplained weight loss, or family history of colorectal cancer

Relevant CPT codes that may be used to treat ICD code K58.1 include:

- 99202–99215 (Evaluation and Management office visits)

- 45378 (Colonoscopy, diagnostic)

- 91110 (Gastrointestinal tract imaging, capsule endoscopy)

- 91120 (Rectal sensation, tone, and compliance test)

- 90935 (Gastrointestinal motility studies)

- 97110 (Therapeutic exercises, if physical therapy is indicated)

- 99401–99404 (Preventive medicine counseling)

- 99406–99407 (Behavior change interventions, if applicable)

CPT code selection depends on the specific services rendered for K58.1.

Schedule a demo to see how MD Clarity’s RevFind software can read your contracts and automatically detect underpayments for CPT codes related to ICD code K58.1. Ensure your practice is accurately reimbursed—discover how RevFind can help you identify missed revenue opportunities today.