What is the ICD‑10‑CM diagnosis code for Small Intestinal Fungal Overgrowth (SIFO)?

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ICD-10-CM Code for Small Intestinal Fungal Overgrowth (SIFO)

There is no specific ICD-10-CM diagnosis code for Small Intestinal Fungal Overgrowth (SIFO), as it is not recognized as a distinct diagnostic entity in the current ICD-10-CM coding system.

Available Coding Options

Since SIFO lacks a dedicated code, you must use alternative codes based on the clinical presentation and documentation:

Primary Coding Approach

  • K63.89 - "Other specified diseases of intestine" is the most appropriate code for SIFO when documenting fungal overgrowth in the small intestine with associated gastrointestinal symptoms 1

  • This code captures intestinal disorders not otherwise classified and allows for documentation of the fungal overgrowth finding 1

Alternative or Supplementary Codes

  • B37.82 - "Candidal enteritis" may be used if Candida species are specifically identified on culture, as Candida is the predominant organism in SIFO 2

  • K90.89 - "Other intestinal malabsorption" can be considered if malabsorption is the primary clinical manifestation 1

  • R14.0 - "Abdominal distension (gaseous)" or R14.3 - "Flatulence" for symptom-based coding when fungal overgrowth is suspected but not definitively proven 1

Clinical Context for Coding

The lack of a specific code reflects that SIFO is an emerging clinical entity with limited recognition in standard diagnostic classifications 1. Recent studies show that 25-26% of patients with unexplained gastrointestinal symptoms have SIFO, with common symptoms including belching, bloating, indigestion, nausea, diarrhea, and gas 1, 2.

Documentation Requirements

  • Document the specific fungal organism identified (typically Candida species) from duodenal aspirate culture 2

  • Note associated risk factors such as proton pump inhibitor use or small intestinal dysmotility, which are independent risk factors for fungal overgrowth 2

  • Record the clinical symptoms and their relationship to the fungal overgrowth finding 1

Common Pitfalls

  • Do not confuse SIFO with systemic candidiasis codes (B37.x series), which are reserved for invasive fungal infections in immunocompromised patients 1

  • Avoid using irritable bowel syndrome codes (K58.x) without first excluding SIFO through appropriate testing, as symptoms overlap significantly 1, 2

  • Remember that SIFO often coexists with Small Intestinal Bacterial Overgrowth (SIBO) in 34% of cases, requiring documentation of both conditions when present 2

References

1
Research

Small intestinal fungal overgrowth.

Current gastroenterology reports, 2015

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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