ICD Code K59.00

ICD code K59.00 is used to classify a diagnosis of constipation when the specific type or cause of constipation is not specified. This code is typically used in medical billing and documentation to indicate that a patient is experiencing constipation, but further details about the condition are not provided. It helps healthcare providers and payers understand the general nature of the patient's condition for treatment and reimbursement purposes.

When considering the use of the ICD code for constipation, unspecified, healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Infrequent Bowel Movements: The patient experiences fewer than three bowel movements per week.

2. Hard or Lumpy Stools: The patient reports passing stools that are hard or lumpy in consistency.

3. Straining During Bowel Movements: The patient frequently strains during bowel movements, indicating difficulty in passing stools.

4. Sensation of Incomplete Evacuation: The patient feels as though their bowel movement is incomplete after passing stools.

5. Sensation of Anorectal Obstruction: The patient experiences a sensation of blockage or obstruction in the anorectal region during bowel movements.

6. Manual Maneuvers to Facilitate Defecation: The patient uses manual maneuvers, such as digital evacuation or support of the pelvic floor, to aid in defecation.

7. Abdominal Discomfort or Bloating: The patient reports abdominal discomfort or bloating associated with infrequent or difficult bowel movements.

8. Chronicity: Symptoms have persisted for at least three months, with onset at least six months prior to diagnosis.

9. Absence of Alarm Symptoms: There are no alarm symptoms present, such as significant weight loss, rectal bleeding, or a family history of colorectal cancer, which would necessitate further investigation.

10. Exclusion of Secondary Causes: Other potential causes of constipation, such as medication side effects, metabolic disorders, or neurological conditions, have been ruled out.

These criteria should be used to guide the clinical decision-making process when determining the appropriateness of using the ICD code for constipation, unspecified.

For the ICD code K59.00 (Constipation, unspecified), relevant CPT codes that may be applicable for treatment or management include:

1. CPT 99201-99215: Evaluation and Management (E/M) codes for office or other outpatient visits. These codes are used for patient consultations and management of conditions like constipation.

2. CPT 45378: Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure). This procedure might be performed to investigate underlying causes of constipation.

3. CPT 74270: Radiologic examination, colon; barium enema, with or without KUB. This imaging procedure can be used to diagnose issues related to constipation.

4. CPT 91110: Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus through ileum, with interpretation and report. This can be used to visualize the gastrointestinal tract for diagnostic purposes.

5. CPT 90901: Biofeedback training by any modality. Biofeedback can be used as a therapeutic approach for managing constipation.

6. CPT 97110: Therapeutic exercises to develop strength and endurance, range of motion, and flexibility. This may be used as part of a treatment plan for constipation.

These CPT codes are examples of procedures and services that might be relevant for the management or investigation of constipation associated with ICD code K59.00. It's important for healthcare providers to select the most appropriate CPT codes based on the specific services rendered and the patient's clinical needs.

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 K59.00. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.