ICD-10 Guide

Opioid Induced Constipation

ICD-10 Coding for Opioid-Induced Constipation(K59.03, T40.4X5A)

PRIMARY SPECIALTYPain Management

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Opioid Induced Constipation?

Essential facts and insights about Opioid-Induced Constipation

Key Clinical Considerations:

Constipation symptoms such as infrequent bowel movements, straining, and hard stools
Patient history of opioid use
Exclusion of other causes of constipation

Clinical Information

Clinical Criteria & Documentation Requirements

Patient's opioid medication history and dosage
Symptoms duration and severity
Assessment of bowel habits and interventions attempted

Coding Guidelines

Usage Guidelines & Examples

Follow guidelines for opioid-related conditions to avoid misclassification.
Common errors include using general constipation codes without specifying opioid use.

Code Exclusions

Important Exclusions

Functional constipation not related to opioid use
Other gastrointestinal disorders causing constipation

Specialty Focus

Primary Specialty

Pain Management

Specialty Applications

Patients on chronic opioid therapy
Pain management clinics and outpatient settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Document opioid use, symptoms, and any treatments tried.

Billing considerations?

Ensure accurate coding to reflect opioid-induced nature for proper reimbursement.

Opioid Induced Constipation

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?

Opioid Induced Constipation

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?