ICD Code K59.04

ICD code K59.04 is chronic idiopathic constipation, which refers to long-term constipation with no identifiable underlying cause.

1. Presence of chronic constipation symptoms for at least 3 months, with symptom onset at least 6 months prior to diagnosis

2. Fewer than three spontaneous bowel movements per week

3. Straining during at least 25% of defecations

4. Lumpy or hard stools in at least 25% of defecations

5. Sensation of incomplete evacuation in at least 25% of defecations

6. Sensation of anorectal obstruction or blockage in at least 25% of defecations

7. Manual maneuvers to facilitate at least 25% of defecations (e.g., digital evacuation, support of the pelvic floor)

8. Absence of loose stools without the use of laxatives

9. Insufficient evidence for irritable bowel syndrome (i.e., abdominal pain is not a predominant symptom)

10. No identifiable secondary cause for constipation after appropriate evaluation

Relevant CPT codes that may be used to treat ICD code K59.04 include:

- 99201–99215 (Evaluation and Management services)

- 45378 (Colonoscopy, diagnostic)

- 45380 (Colonoscopy with biopsy)

- 45330 (Sigmoidoscopy, diagnostic)

- 91120 (Gastrointestinal transit and motility studies)

- 90911 (Biofeedback training, perineal muscles, anorectal or pelvic floor)

- 97110 (Therapeutic exercises)

- 97112 (Neuromuscular reeducation)

- 96372 (Therapeutic, prophylactic, or diagnostic injection)

- 99401–99404 (Preventive medicine counseling)

CPT code selection should be based on the specific services rendered for K59.04.

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