K59.04

K59.04: Chronic idiopathic constipation

Billable / specific codeICD-10-CM

K59.04 is a billable, specific ICD-10-CM code for chronic idiopathic constipation. It is valid for submission on a claim.

Check K59.04 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Functional constipation

Excludes1 inherited from the categories above K59.04

A category’s note binds every code beneath it.

Written on K59.0: Constipation

fecal impaction (K56.41)

Written on K59: Other functional intestinal disorders

change in bowel habit NOS (R19.4)
intestinal malabsorption (K90.-)
psychogenic intestinal disorders (F45.8)

Excludes2 inherited from the categories above K59.04

Not part of this code, but both may be coded when both are present.

Written on K59.0: Constipation

incomplete defecation (R15.0)

Written on K59: Other functional intestinal disorders

functional disorders of stomach (K31.-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

K59.04 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A54095Billing and Coding: Nerve Conduction Studies and Electromyography
A55937Billing and Coding: Diagnostic Colonoscopy
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56421Billing and Coding: CT of the Abdomen and Pelvis

Alphabetic index entries that lead here

Constipation›functional
Constipation›chronic›idiopathic

Code history

Unchanged in every release from FY2024 to FY2027.