ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK58

K58

Non-billable

Irritable bowel syndrome

Chapter 11:Diseases of the digestive system

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K58 is a used to indicate a diagnosis of irritable bowel syndrome.

Key Diagnostic Point:

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by a group of symptoms that typically include abdominal pain, bloating, and altered bowel habits, which may manifest as diarrhea, constipation, or a combination of both. The exact etiology of IBS remains unclear, but it is believed to involve a complex interplay of gut-brain interactions, dysregulation of gastrointestinal motility, and visceral hypersensitivity. The anatomy involved primarily includes the intestines, particularly the colon, which may exhibit abnormal contractions. Disease progression can vary widely among individuals, with symptoms often fluctuating in intensity and frequency. Diagnostic considerations for IBS include a thorough patient history, symptom assessment, and exclusion of other gastrointestinal conditions through tests such as stool studies, imaging, and endoscopy. The Rome IV criteria are commonly used to diagnose IBS, requiring the presence of abdominal pain at least one day per week in the last three months, associated with changes in stool frequency or form. IBS is a chronic condition that can significantly impact quality of life, necessitating a multidisciplinary approach to management, including dietary modifications, pharmacotherapy, and psychological support.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as IBS symptoms overlap with other gastrointestinal disorders.
  • Treatment complexity: Moderate, involving lifestyle changes and medications.
  • Documentation requirements: Moderate, requiring detailed symptom descriptions and exclusion of other conditions.
  • Coding specificity: Medium, as K58 encompasses various subtypes of IBS.

Audit Risk Factors

  • Common coding errors: Misclassification of IBS subtypes.
  • Documentation gaps: Incomplete symptom descriptions or lack of diagnostic criteria fulfillment.
  • Billing challenges: Denials due to insufficient documentation or misinterpretation of symptoms.

Specialty Focus

Medical Specialties

Primary medical specialty: Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Irritable bowel syndrome has significant clinical implications, affecting approximately 10-15% of the global population. It can lead to increased healthcare utilization due to frequent doctor visits, diagnostic testing, and treatments. The condition impacts quality of life, with many patients experiencing anxiety and depression related to their symptoms. Understanding IBS is crucial for improving population health outcomes, as effective management can reduce healthcare costs and improve patient satisfaction.

ICD-9 vs ICD-10

Irritable bowel syndrome has significant clinical implications, affecting approximately 10-15% of the global population. It can lead to increased healthcare utilization due to frequent doctor visits, diagnostic testing, and treatments. The condition impacts quality of life, with many patients experiencing anxiety and depression related to their symptoms. Understanding IBS is crucial for improving population health outcomes, as effective management can reduce healthcare costs and improve patient satisfaction.

Reimbursement & Billing Impact

Reimbursement considerations include understanding the payer's policies on IBS management and ensuring that all claims are submitted with appropriate modifiers when necessary. Common denials may arise from lack of supporting documentation or failure to meet medical necessity criteria, so thorough documentation is essential. Coding best practices include using the most specific code available and regularly updating knowledge on payer guidelines.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K58?

K58 covers Irritable Bowel Syndrome, which includes subtypes such as IBS with predominant diarrhea (IBS-D), IBS with predominant constipation (IBS-C), and mixed IBS (IBS-M). Each subtype is characterized by specific bowel habit changes and symptom patterns.

When should K58 be used instead of related codes?

K58 should be used when a patient presents with symptoms consistent with IBS, particularly when other gastrointestinal conditions have been ruled out. It is important to differentiate IBS from inflammatory bowel disease (IBD) or other functional gastrointestinal disorders.

What documentation supports K58?

Documentation for K58 should include a detailed patient history, symptom diary, results from any relevant diagnostic tests, and a clear statement of the diagnosis based on the Rome IV criteria.