Constipation is one of the most commonly reported gastrointestinal issues in clinical practice, yet accurately coding it—especially when it comes to the Constipation ICD 10 code—can be a challenge due to variations like chronic or opioid-induced constipation.
For healthcare providers, clinical coders, and billing teams, understanding the correct Constipation ICD 10 codes isn’t just about compliance—it’s about ensuring accurate documentation, seamless claims processing, and ultimately, better patient outcomes.
In this article, we will explore everything you need to know about the ICD 10 Code for Constipation, offering real-world examples, billing tips, and insights into coding for chronic and drug-induced constipation.
What is the ICD 10 Code for Constipation?
When documenting a diagnosis of constipation, the key to proper reimbursement and clinical clarity lies in selecting the correct ICD-10 code. The ICD 10 Code for Constipation is K59.00, which denotes Constipation, unspecified. This is used when the provider has not identified a specific cause or type of constipation in the patient.
Code: K59.00 – Constipation, unspecified
This is the default code when no additional specification is available in the medical record. It applies to general constipation without a chronic or drug-induced diagnosis.
Coding Tip:
To reduce claim rejections, ensure documentation supports this as a non-specific or first-time presentation of constipation. If more details are available—like chronicity or drug association—use a more specific code instead.
ICD 10 Constipation Code Breakdown
To improve the accuracy of your medical documentation and billing processes, it’s essential to understand the different ICD-10 codes available for constipation.
K59.00 – Constipation, unspecified
Use when: No specific cause or type is documented.
Excludes:
- Fecal impaction (K56.41)
- Incomplete defecation (R15.0)
- Change in bowel habit, NOS (R19.4)
K59.04 – Chronic idiopathic constipation
This code refers to persistent constipation without a known secondary cause. Often used in cases like irritable bowel syndrome or functional bowel disorders.
- Use when: The patient has long-term, non-drug-induced constipation with no organic explanation.
- Document: Duration, patient history, prior treatments, and lack of structural or medication causes.
- Clinical Note: Common in geriatrics and patients with neurological conditions.
How to Code Opioid Induced Constipation ICD 10?
One of the most frequently missed documentation opportunities is opioid-induced constipation, which has a specific ICD-10 code: K59.03 – Drug-induced constipation. Opioids slow gut motility, leading to this common complication.
K59.03 – Drug-induced constipation
Use when: Constipation is directly caused by a prescribed medication, particularly opioids.
Document:
- Name of the drug
- Start date of usage
- Relationship to symptoms
- Confirmation of drug-related cause
Coding Best Practice:
Always link this with the underlying condition being treated (e.g., chronic pain) and the name of the medication. If using a pain diagnosis (like M54.5 for low back pain), this provides additional coding accuracy and supports reimbursement.
Billing Guidelines for Constipation ICD 10 Codes
Accurate ICD-10 coding not only helps with compliance but ensures that providers are reimbursed appropriately for their services. Here’s how to optimize billing when coding for constipation.
General Billing Tips:
Be Specific: Use the most specific ICD-10 code available based on clinical documentation. Avoid defaulting to K59.00 if a more accurate code like K59.04 or K59.03 applies.
Match Symptoms to Documentation: Ensure that your documentation clearly supports the selected code with symptom duration, patient history, and any related medications or conditions.
Link Related Conditions: For drug-induced constipation, include the medication that caused it and the condition being treated.
Check Exclusion Notes: Be mindful of Excludes1 and Excludes2 notes to avoid incorrect or conflicting code assignments.
Common Payer Requirements:
- Medical Necessity: Ensure the code aligns with the services billed (e.g., evaluation, diagnostic studies, medications).
- Chronic Conditions: Chronic constipation codes (K59.04) often require supporting documentation over time.
- Opioid Use Justification: For K59.03, include drug names and dosages in notes, and use prescription history to establish linkage.
Coding Tips & Clinical Scenarios
Understanding real-life scenarios helps reinforce accurate ICD-10 usage.
Example 1: General constipation
Scenario: A 30-year-old reports new-onset constipation with no known cause.
Code: K59.00 – Constipation, unspecified
Example 2: Chronic idiopathic constipation
Scenario: A 65-year-old with a 6-month history of constipation, no known medication or structural cause.
Code: K59.04 – Chronic idiopathic constipation
Example 3: Opioid-induced constipation
Scenario: A patient taking hydrocodone for chronic back pain reports significant constipation.
Code: K59.03 – Drug-induced constipation
Exclusion Notes to Watch
ICD-10 has specific Excludes1 and Excludes2 notes that must be followed to avoid coding errors.
Excludes1 (Not coded together):
- K56.41 – Fecal impaction
- R15.0 – Incomplete defecation
- R19.4 – Change in bowel habit NOS
Excludes2 (May be coded separately if applicable):
- K90.- – Intestinal malabsorption
- K31.- – Functional disorders of stomach
- F45.8 – Psychogenic intestinal disorders
Tip: Always refer to the Tabular List for current Excludes notes as they can affect reimbursement eligibility.
Bottom Line
Coding constipation accurately is more than checking a box—it’s a clinical and financial necessity. Whether you’re dealing with routine constipation, chronic conditions, or complications due to medications like opioids, there’s a precise ICD-10 code to use.
By understanding when and how to use:
- K59.00 for unspecified cases
- K59.04 for chronic idiopathic constipation
- K59.03 for drug-induced constipation
…you improve care coordination, streamline claims, and protect your practice from audits and billing denials.
