ICD Code K58.9

ICD code K58.9 is used to identify a diagnosis of irritable bowel syndrome (IBS) without specifying any particular subtype or additional details. This code is applied when a patient exhibits symptoms consistent with IBS, such as abdominal pain, bloating, and altered bowel habits, but the healthcare provider does not specify whether it is diarrhea-predominant, constipation-predominant, or mixed. It serves as a general classification for IBS in medical records and billing.

1. Recurrent Abdominal Pain or Discomfort: The patient experiences abdominal pain or discomfort that occurs at least one day per week in the last three months.

2. Change in Stool Frequency: There is a noticeable change in how often the patient has bowel movements, either more frequent or less frequent than usual.

3. Change in Stool Form or Appearance: The patient reports a change in the consistency or appearance of their stool, such as becoming harder, softer, or more watery.

4. Onset of Symptoms: Symptoms must have started at least six months prior to diagnosis, with active symptoms present for the last three months.

5. Absence of Alarm Features: There should be no alarming symptoms such as significant weight loss, gastrointestinal bleeding, or family history of colorectal cancer that would suggest a more serious condition.

6. Exclusion of Other Conditions: Other gastrointestinal disorders, such as inflammatory bowel disease or celiac disease, should be ruled out through appropriate testing.

7. Symptom Relief with Defecation: The patient may experience relief from abdominal pain or discomfort after having a bowel movement.

8. Bloating or Distension: The patient may report feelings of bloating or visible abdominal distension.

9. Non-Gastrointestinal Symptoms: Some patients may also experience non-gastrointestinal symptoms such as fatigue or headaches, although these are not primary diagnostic criteria.

10. Psychosocial Factors: Consideration of stress, anxiety, or depression that may exacerbate symptoms, although these are not diagnostic criteria, they can influence symptom severity.

For the ICD code K58.9, which pertains to irritable bowel syndrome, unspecified, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99215: Evaluation and Management (E/M) services for new or established patients, depending on the complexity and time spent during the visit.

2. 45378: Colonoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure).

3. 91010: Esophageal motility (manometric) study, each 15 minutes of recording.

4. 91110: Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus through ileum, with physician interpretation and report.

5. 94640: Pressurized or non-pressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes.

6. G0104: Colorectal cancer screening; flexible sigmoidoscopy.

7. G0105: Colorectal cancer screening; colonoscopy on individual at high risk.

These CPT codes are examples of procedures and services that may be utilized in the management and treatment of conditions associated with ICD code K58.9. It's important for healthcare providers to select the appropriate CPT codes based on the specific services rendered and the patient's clinical situation.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments for CPT codes related to ICD code K58.9. Schedule a demo today to see how RevFind can help ensure you're receiving the full reimbursement you deserve.