ICD-10 Coding for Hilar Lymph Nodes(D86.1, R59.0, C34.90)
Complete ICD-10-CM coding and documentation guide for Hilar Lymph Nodes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hilar Lymph Nodes
D86-D86.9Primary Range
Sarcoidosis
This range includes sarcoidosis of hilar lymph nodes, which is a common cause of hilar lymphadenopathy.
Enlarged Lymph Nodes
This range covers lymphadenopathy without a specified cause, applicable when the etiology is unknown.
Malignant Neoplasm of Bronchus and Lung
This range is relevant when hilar lymph node involvement is due to lung cancer.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D86.1 | Sarcoidosis of lung | Use when sarcoidosis is confirmed by biopsy or clinical findings. |
|
| R59.0 | Localized enlarged lymph nodes | Use when lymphadenopathy is present without a confirmed cause. |
|
| C34.90 | Malignant neoplasm of unspecified part of bronchus or lung | Use when hilar lymph node involvement is due to lung cancer. |
|
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 sarcoidosis of hilar lymph nodes
Essential facts and insights about Hilar Lymph Nodes
Primary ICD-10-CM Codes for hilar lymph nodes
Decision Criteria
clinical Criteria
- Biopsy confirms non-caseating granulomas
documentation Criteria
- Documented elevated ACE levels
Applicable To
- Sarcoidosis of hilar lymph nodes
Excludes
- Lung cancer with hilar involvement
Clinical Validation Requirements
- Biopsy showing non-caseating granulomas
- Elevated ACE levels
- Bilateral symmetrical hilar adenopathy on imaging
Code-Specific Risks
- Misclassification if biopsy is not confirmed
Coding Notes
- Ensure biopsy confirmation for sarcoidosis to avoid incorrect coding.
R59.0 - Localized enlarged lymph nodes
Use when lymphadenopathy is present without a confirmed cause.
Applicable To
- Unilateral hilar lymphadenopathy
Excludes
- Sarcoidosis of hilar lymph nodes
Clinical Validation Requirements
- Imaging showing unilateral enlargement
- No biopsy confirmation of specific etiology
Coding Notes
Avoid using R59.0 if a specific cause like sarcoidosis is confirmed.
C34.90 - Malignant neoplasm of unspecified part of bronchus or lung
Use when hilar lymph node involvement is due to lung cancer.
Applicable To
- Lung cancer with hilar nodal involvement
Excludes
- Benign conditions of hilar lymph nodes
Clinical Validation Requirements
- Biopsy confirmation of malignancy
- Imaging showing mass with nodal involvement
Coding Notes
Ensure malignancy is confirmed through biopsy before coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hilar Lymph Nodes to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D86.1.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure biopsy results are included in all relevant documentation., Regular training on documentation standards.
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use D86.1 when sarcoidosis is confirmed by biopsy.
Impact
Lack of biopsy documentation for sarcoidosis coding.
Mitigation Strategy
Implement mandatory biopsy documentation checks.
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 Hilar Lymph Nodes, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hilar Lymph Nodes
Use these documentation templates to ensure complete and accurate documentation for Hilar Lymph Nodes. These templates include all required elements for proper coding and billing.
Biopsy-confirmed sarcoidosis
Specialty: PulmonologyRequired Elements
- Biopsy results
- ACE levels
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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