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ICD-10 Guide
ICD-10 CodesK58.8

K58.8

Billable

Other irritable bowel syndrome

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

Code Description

ICD-10 K58.8 is a billable code used to indicate a diagnosis of other irritable bowel syndrome.

Key Diagnostic Point:

K58.8 refers to 'Other irritable bowel syndrome,' a gastrointestinal disorder characterized by a group of symptoms affecting the large intestine, including abdominal pain, bloating, gas, diarrhea, and constipation. The clinical presentation can vary significantly among patients, with some experiencing predominant diarrhea (IBS-D), others constipation (IBS-C), and some alternating between the two (IBS-A). The anatomy involved primarily includes the colon and rectum, where motility and sensitivity are often altered. Disease progression can be chronic, with symptoms fluctuating in intensity and frequency, often exacerbated by stress, dietary factors, or hormonal changes. Diagnostic considerations include a thorough patient history, symptom assessment, and exclusion of other gastrointestinal disorders such as inflammatory bowel disease (IBD) or celiac disease. Diagnostic criteria may involve the Rome IV criteria, which focus on symptom patterns over a specified duration. It is essential for healthcare providers to differentiate K58.8 from other IBS subtypes and gastrointestinal conditions to ensure appropriate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires exclusion of other conditions.
  • Treatment complexity: Moderate, with various management strategies including dietary changes, medications, and psychological support.
  • Documentation requirements: Moderate, necessitating detailed symptom descriptions and history.
  • Coding specificity: Medium, as it requires differentiation from other IBS codes.

Audit Risk Factors

  • Common coding errors: Misclassification of IBS subtypes.
  • Documentation gaps: Incomplete symptom history or lack of exclusion of other conditions.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

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 ICD-10 Codes

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

K58.8 has significant clinical implications, affecting a substantial portion of the population with gastrointestinal complaints. Its management is crucial for improving quality of life and reducing healthcare utilization patterns associated with recurrent gastrointestinal symptoms. Understanding the epidemiology of IBS, including its prevalence and impact on daily functioning, is essential for healthcare providers to implement effective treatment strategies and improve patient outcomes.

ICD-9 vs ICD-10

K58.8 has significant clinical implications, affecting a substantial portion of the population with gastrointestinal complaints. Its management is crucial for improving quality of life and reducing healthcare utilization patterns associated with recurrent gastrointestinal symptoms. Understanding the epidemiology of IBS, including its prevalence and impact on daily functioning, is essential for healthcare providers to implement effective treatment strategies and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear symptom descriptions and the exclusion of other gastrointestinal disorders. Common denials may arise from insufficient documentation or lack of clarity in the diagnosis. Best practices involve ensuring that all clinical notes are thorough and that the rationale for the chosen treatment is well-documented. Providers should also be aware of payer-specific guidelines that may affect reimbursement.

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 K58.8?

K58.8 encompasses various forms of irritable bowel syndrome that do not fit into the defined categories of IBS-D or IBS-C. This includes atypical presentations and symptoms that do not align with the standard classifications, requiring careful clinical evaluation.

When should K58.8 be used instead of related codes?

K58.8 should be used when a patient presents with IBS symptoms that do not conform to the predominant diarrhea or constipation types, particularly when other gastrointestinal disorders have been ruled out.

What documentation supports K58.8?

Documentation should include a detailed patient history, symptom frequency and duration, results from diagnostic tests that exclude other conditions, and any treatment responses. A clear narrative of the patient's experience with symptoms is crucial.