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ICD-10 Guide
ICD-10 CodesK58.0

K58.0

Billable

Irritable bowel syndrome with diarrhea

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

Code Description

ICD-10 K58.0 is a billable code used to indicate a diagnosis of irritable bowel syndrome with diarrhea.

Key Diagnostic Point:

Irritable bowel syndrome with diarrhea (IBS-D) is a functional gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits, specifically diarrhea. The pathophysiology of IBS-D involves a complex interplay of gut-brain interactions, altered gut motility, visceral hypersensitivity, and changes in gut microbiota. Patients typically present with symptoms such as frequent loose stools, urgency, and abdominal discomfort that may improve after bowel movements. The anatomy involved includes the large intestine, where motility and secretion are disrupted. Disease progression can vary, with some patients experiencing intermittent symptoms while others may have more persistent issues. Diagnostic considerations for IBS-D include a thorough clinical history, symptom assessment, and exclusion of other gastrointestinal conditions such as inflammatory bowel disease (IBD) or infections. The Rome IV criteria are often utilized for diagnosis, requiring recurrent abdominal pain at least one day per week in the last three months, associated with changes in stool frequency or form. Laboratory tests and imaging are generally not required unless other conditions are suspected.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

Specialty Focus

Medical Specialties

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

Primary Care

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 ICD-10 Codes

Related CPT Codes

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 with diarrhea significantly impacts patient quality of life, leading to increased healthcare utilization and costs. It is prevalent in the population, affecting approximately 10-15% of adults, and is associated with comorbid conditions such as anxiety and depression. Quality measures related to IBS-D focus on symptom management and patient education, aiming to improve overall health outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Irritable bowel syndrome with diarrhea significantly impacts patient quality of life, leading to increased healthcare utilization and costs. It is prevalent in the population, affecting approximately 10-15% of adults, and is associated with comorbid conditions such as anxiety and depression. Quality measures related to IBS-D focus on symptom management and patient education, aiming to improve overall health outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

impact on their daily life. Reimbursement considerations include the need for clear clinical evidence of IBS-D, as well as the potential for denials if documentation does not sufficiently support the diagnosis. Common billing challenges include ensuring that the documentation aligns with the ICD-10 code selected and that all relevant symptoms are captured. Best practices include regular training for coding staff on the nuances of IBS coding and maintaining thorough patient records.

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 K58.0?

K58.0 specifically covers irritable bowel syndrome with diarrhea, characterized by recurrent abdominal pain and diarrhea. It excludes other forms of IBS that may present with constipation or mixed symptoms.

When should K58.0 be used instead of related codes?

K58.0 should be used when the patient presents with predominant diarrhea as a symptom of IBS. It is important to differentiate it from K58.1, which is used for IBS with constipation.

What documentation supports K58.0?

Documentation should include a detailed patient history, symptom frequency and duration, and any diagnostic tests performed to rule out other conditions. The use of the Rome IV criteria for diagnosis should also be noted.