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ICD-10 Guide
ICD-10 CodesK59.09

K59.09

Billable

Other constipation

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

Code Description

ICD-10 K59.09 is a billable code used to indicate a diagnosis of other constipation.

Key Diagnostic Point:

K59.09 refers to 'Other constipation,' which encompasses various forms of constipation not classified under more specific codes. Clinically, constipation is characterized by infrequent bowel movements, typically defined as fewer than three per week, and may involve straining during defecation, hard or lumpy stools, and a sensation of incomplete evacuation. The gastrointestinal tract, particularly the colon and rectum, is primarily involved in this condition. The etiology of constipation can be multifactorial, including dietary factors (low fiber intake), inadequate fluid consumption, sedentary lifestyle, medications, and underlying medical conditions such as hypothyroidism or diabetes. Disease progression may lead to complications such as fecal impaction or bowel obstruction if left untreated. Diagnostic considerations include a thorough patient history, physical examination, and potentially imaging studies or laboratory tests to rule out secondary causes. Identifying the underlying cause is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other gastrointestinal disorders.
  • Treatment complexity: Moderate, involving lifestyle changes, dietary modifications, and possibly pharmacotherapy.
  • Documentation requirements: Moderate, necessitating detailed patient history and clinical findings.
  • Coding specificity: Medium, as it requires understanding of the broader category of constipation.

Audit Risk Factors

  • Common coding errors: Misclassification with more specific codes.
  • Documentation gaps: Lack of detailed patient history or clinical findings.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

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

Constipation is a prevalent condition affecting a significant portion of the population, leading to increased healthcare utilization and costs. It can impact quality of life and may result in complications if not managed effectively. Understanding the epidemiology of constipation, including its risk factors and associated comorbidities, is crucial for improving patient outcomes and implementing effective public health strategies.

ICD-9 vs ICD-10

Constipation is a prevalent condition affecting a significant portion of the population, leading to increased healthcare utilization and costs. It can impact quality of life and may result in complications if not managed effectively. Understanding the epidemiology of constipation, including its risk factors and associated comorbidities, is crucial for improving patient outcomes and implementing effective public health strategies.

Reimbursement & Billing Impact

reimbursement. Regular audits of coding practices can help identify areas for improvement and reduce the risk of denials.

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 K59.09?

K59.09 covers various forms of constipation that do not fit into the more specific categories, including idiopathic constipation, constipation due to dietary factors, and constipation associated with certain medications or lifestyle factors.

When should K59.09 be used instead of related codes?

K59.09 should be used when the constipation is not classified under K59.00 or K59.01, particularly when the cause is unclear or when it is due to factors that do not have a specific code.

What documentation supports K59.09?

Documentation should include a detailed patient history, including bowel habits, dietary intake, medication use, and any relevant physical examination findings. Additionally, any diagnostic tests performed should be documented.