This document discusses medical coding for Irritable Bowel Syndrome (IBS). It provides the ICD-10 codes used to document IBS and its subtypes based on symptoms. It also lists relevant CPT codes for office visits, diagnostic procedures, blood tests, and stool examinations related to evaluating and managing IBS. Proper documentation and accurate coding is important for reimbursement.

1. Medical Codes to Report
IBS – A Common
Gastrointestinal Disorder
Summary – This blog discusses Irritable Bowel Syndrome
(IBS) and its medical codes.
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A chronic gastrointestinal disorder affecting millions of people worldwide, Irritable Bowel
Syndrome (IBS) is characterized by recurrent abdominal pain or discomfort associated
with changes in bowel habits. The condition, also known as spastic colitis, mucous colitis,
and nervous colon, primarily affects the stomach and intestines (gastrointestinal tract).
Billing and coding for this gastrointestinal disorder can be challenging. Proper
documentation and accurate reporting of the condition is crucial for accurate
reimbursement. Gastroenterologists and other specialists can rely on medical billing
companies to report IBS diagnosis and treatment accurately.
Symptoms and Causes
As per recent reports, about 45 million people living in the United States suffer from
irritable bowel syndrome. The exact cause of IBS is not known. However, several factors
can increase the risks of the condition. These include –
• Bacterial infections in the digestive tract
• Hormonal changes
• Food intolerances
• Muscle contractions in the intestine
Symptoms include abdominal pain, cramping, or bloating that is related to passing a
bowel movement; changes in appearance of bowel movement, and changes in how often
bowel movements occur. Diagnosing irritable bowel syndrome (IBS) involves assessing
the symptoms. Medical history, physical exams, and sometimes tests help rule out other
conditions and confirm IBS.
Medical Codes to Report IBS
Coding for IBS involves selecting the appropriate ICD-10 diagnosis codes and CPT
(Current Procedural Terminology) codes.
ICD-10 Codes
While the primary diagnosis code for IBS is K58.9, it is worth noting that IBS can be
further classified into subtypes based on the predominant bowel pattern: IBS with
diarrhea (IBS-D), IBS with constipation (IBS-C), or mixed IBS (IBS-M). Documenting the
specific subtype, if known, can provide additional information; add specificity of the
code, and help tailor treatment plans. The following ICD-10-CM codes can be used for
subtype identification –

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• K58 – Irritable bowel syndrome
• K58.0 – Irritable bowel syndrome with diarrhea
• K58.1 – Irritable bowel syndrome with constipation
• K58.2 – Mixed irritable bowel syndrome
• K58.8 – Other irritable bowel syndrome
• K58.9 – Irritable bowel syndrome without diarrhea
CPT Codes
Evaluation and Management (E/M) Codes
• Office or other outpatient visits, new patient - Code range - 99201-99205
• Office or other outpatient visits, established patient - Code range - 99211-99215
Diagnostic Procedures
• Colonoscopy - Code range - 45378-45398
• Sigmoidoscopy - Code range - 45330-45347
• Complete Blood Count (CBC) – Code - 85025
• Comprehensive Metabolic Panel (CMP) – Code - 80053
• Stool culture – Code - 87045
• Stool examination, ova, and parasites – Code – 87177
The specific CPT codes reported will depend on the services provided and the
documentation supporting those services. Staying updated with the latest coding
guidelines is crucial to maintaining compliance and maximizing reimbursement.