Find information on severe constipation diagnosis, including clinical documentation, medical coding (ICD-10 K59.0, K59.00, K59.04, N84, R19.4), and healthcare guidance. Learn about symptoms, treatment, and management of severe constipation for accurate medical records and optimized patient care. Explore resources for healthcare professionals related to obstipation, fecal impaction, and chronic constipation.
Also known as
Constipation
Functional constipation, slow transit, or outlet dysfunction.
Slow transit constipation
Slow movement of stool through the colon.
Other functional constipation
Constipation not otherwise specified.
Other abdominal pain
May be associated with severe constipation in some cases.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is obstipation present?
Yes
Is obstipation due to obstruction?
No
Is constipation slow transit?
When to use each related code
| Description |
|---|
| Severe Constipation |
| Functional Constipation |
| Opioid-Induced Constipation |
Coding K59.0 without documented severity or etiology risks downcoding and lost revenue. CDI should query for specifics like chronic or opioid-induced.
IBS, pelvic floor dysfunction, or neurological conditions can coexist with constipation. Accurate coding of all diagnoses is crucial for proper reimbursement.
Lack of clinical indicators like frequency, consistency, and straining in the documentation can lead to coding denials. CDI should ensure comprehensive charting.
Q: What are the most effective evidence-based treatment strategies for managing severe constipation refractory to standard laxative therapy in adult patients?
A: Managing severe constipation refractory to standard laxative therapy requires a multifaceted approach. Beyond increasing fiber and fluid intake, consider implementing strategies like biofeedback therapy for pelvic floor dysfunction, exploring the use of secretagogues like lubiprostone or linaclotide, and evaluating for potential underlying anatomical or physiological issues. For patients with slow colonic transit, prucalopride may be beneficial. In cases of opioid-induced constipation, peripheral mu-opioid receptor antagonists (PAMORAs) like naloxegol or methylnaltrexone can be considered. Surgical intervention is typically a last resort for severe, intractable constipation unresponsive to other therapies. Explore how combining pharmacological and behavioral interventions can improve patient outcomes. Learn more about the Rome IV criteria for diagnosing functional constipation.
Q: How can clinicians differentiate between slow transit constipation and outlet obstruction constipation when evaluating a patient with chronic severe constipation symptoms?
A: Differentiating slow transit constipation (STC) from outlet obstruction constipation (OOC) involves a comprehensive evaluation. While both present with infrequent bowel movements and straining, several key factors aid in distinction. Colonic transit studies using radiopaque markers help assess colonic motility and can pinpoint slow transit characteristic of STC. Anorectal manometry and defecography evaluate pelvic floor muscle function and coordination during defecation, revealing potential dyssynergic defecation or anatomical obstructions suggestive of OOC. Consider implementing digital rectal examination to assess for anal sphincter tone and rectal masses. Symptoms like incomplete evacuation and excessive straining are more common in OOC. Explore how physiological testing can improve diagnostic accuracy and tailor treatment strategies for optimal patient management. Learn more about the diagnostic criteria for dyssynergic defecation.
Patient presents with complaints consistent with severe constipation, characterized by infrequent bowel movements, significant straining, and hard stools. Symptoms include reduced stool frequency (less than three bowel movements per week), sensation of incomplete evacuation, abdominal discomfort, bloating, and straining during defecation. The patient reports experiencing these symptoms for several months, impacting their quality of life. On physical examination, abdominal palpation revealed mild distention and tenderness in the lower left quadrant. Digital rectal exam confirmed the presence of hard stool in the rectum. Review of systems is negative for significant weight loss, nausea, vomiting, or blood in stool. No history of abdominal surgery. Current medications include [list medications]. Allergies include [list allergies]. Assessment: Severe constipation (ICD-10 K59.04), likely functional constipation based on Rome IV criteria. Plan: Initial management will focus on increasing dietary fiber intake, increasing fluid intake, and initiating a bowel retraining program. Prescribed osmotic laxative, polyethylene glycol 3350 (Miralax), daily for symptom relief. Patient education provided on lifestyle modifications including regular exercise and establishing a consistent toileting schedule. Follow-up scheduled in two weeks to assess response to treatment and consider further diagnostic testing if symptoms persist, such as abdominal x-ray or colonoscopy to rule out other potential causes of constipation, including slow transit constipation or obstructive defecation. Patient advised to return to the clinic sooner if symptoms worsen or new symptoms develop such as severe abdominal pain, rectal bleeding, or vomiting. Medical coding: Diagnosis code K59.04.