ICD-10 Coding for Enlarged Lymph Node(R59.0, R59.1, R59.9, I88.9)
Complete ICD-10-CM coding and documentation guide for Enlarged Lymph Node. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Enlarged Lymph Node
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R59.0 | Localized enlarged lymph nodes | Use when lymphadenopathy is confined to a single region and no underlying cause is identified. |
|
| R59.1 | Generalized enlarged lymph nodes | Use when lymphadenopathy is present in two or more non-contiguous regions. |
|
| R59.9 | Enlarged lymph nodes, unspecified | Use only when no specific location or cause is documented. |
|
| I88.9 | Nonspecific lymphadenitis | Use when inflammation of lymph nodes is confirmed. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for localized enlarged lymph nodes
Essential facts and insights about Enlarged Lymph Node
Primary ICD-10-CM Codes for enlarged lymph node
Decision Criteria
clinical Criteria
- Node size and location must be documented.
Applicable To
- Cervical lymphadenopathy
- Axillary lymphadenopathy
Clinical Validation Requirements
- Ultrasound showing node size ≥1.5 cm
- Palpable nodes in a single region
Code-Specific Risks
- Risk of using without specifying location
Coding Notes
- Ensure to document the specific location of the lymphadenopathy.
R59.1 - Generalized enlarged lymph nodes
Use when lymphadenopathy is present in two or more non-contiguous regions.
Applicable To
- Lymphadenopathy in multiple regions
Excludes
- Localized lymphadenopathy (R59.0)
- Lymphadenitis (I88.9)
Clinical Validation Requirements
- CT/PET scan showing nodes in multiple regions
- Associated symptoms like fever and weight loss
Coding Notes
Document all regions involved and any systemic symptoms.
R59.9 - Enlarged lymph nodes, unspecified
Use only when no specific location or cause is documented.
Applicable To
- Swollen glands, NOS
Excludes
- Localized lymphadenopathy (R59.0)
- Generalized lymphadenopathy (R59.1)
Clinical Validation Requirements
- Vague documentation without specific location
Coding Notes
Avoid using if more specific information is available.
I88.9 - Nonspecific lymphadenitis
Use when inflammation of lymph nodes is confirmed.
Applicable To
- Inflammation of lymph nodes, NOS
Excludes
- Lymphadenopathy without inflammation (R59.0-R59.9)
Clinical Validation Requirements
- CRP >10 mg/L, positive culture
Coding Notes
Ensure documentation of inflammatory signs.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Enlarged Lymph Node to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R59.0.
Impact
Clinical: Inaccurate clinical picture and treatment plan, Regulatory: Non-compliance with coding guidelines, Financial: Potential for denied claims or reduced reimbursement
Mitigation Strategy
Always assess and document potential underlying causes, Use additional codes for confirmed conditions
Impact
Reimbursement: Reduced reimbursement due to lack of specificity, Compliance: Non-compliance with coding guidelines, Data Quality: Poor data quality and inaccurate clinical records
Mitigation Strategy
Specify R59.0 or R59.1 with exact site
Impact
Reimbursement: Incorrect DRG assignment affecting reimbursement, Compliance: Violation of sequencing rules, Data Quality: Misleading clinical data regarding treatment focus
Mitigation Strategy
Code lymphoma first if treatment is directed at cancer
Impact
Frequent use of R59.9 can trigger audits due to lack of specificity.
Mitigation Strategy
Encourage detailed documentation and use of specific codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Enlarged Lymph Node, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Enlarged Lymph Node
Use these documentation templates to ensure complete and accurate documentation for Enlarged Lymph Node. These templates include all required elements for proper coding and billing.
Localized lymphadenopathy due to infection
Specialty: Internal MedicineRequired Elements
- Location and size of lymph nodes
- Tenderness and consistency
- Associated symptoms
- Diagnostic tests and results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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