K59.1
K59.1: Functional diarrhea
Billable / specific codeICD-10-CM
K59.1 is a billable, specific ICD-10-CM code for functional diarrhea. It is valid for submission on a claim.
Check K59.1 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes1 inherited from the categories above K59.1
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above K59.1
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with K59.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
K59.1 is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Alphabetic index entries that lead here
- Diarrhea, diarrheal›functional
- Diarrhea, diarrheal›neurogenic
Code history
Unchanged in every release from FY2024 to FY2027.