ICD-10 Coding for Hilar Lymphadenopathy(R59.0, D86.1, C78.01)
Complete ICD-10-CM coding and documentation guide for Hilar Lymphadenopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hilar Lymphadenopathy
R59Primary Range
Enlarged lymph nodes
This range includes codes for lymphadenopathy, which is relevant for hilar lymphadenopathy.
Secondary malignant neoplasm of respiratory and digestive organs
This range includes codes for metastatic cancer to hilar lymph nodes.
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 hilar lymphadenopathy is localized without systemic involvement. |
|
| D86.1 | Sarcoidosis of lung | Use when sarcoidosis is confirmed and involves the lungs. |
|
| C78.01 | Secondary malignant neoplasm of right lung | Use when metastasis to right hilar 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 hilar lymphadenopathy
Essential facts and insights about Hilar Lymphadenopathy
Primary ICD-10-CM Codes for hilar lymphadenopathy
Decision Criteria
clinical Criteria
- Imaging confirms localized hilar lymphadenopathy
Applicable To
- Localized hilar lymphadenopathy
Excludes
- Generalized lymphadenopathy (R59.1)
Clinical Validation Requirements
- Imaging showing localized hilar lymphadenopathy
- Absence of systemic disease
Code-Specific Risks
- Risk of undercoding if systemic involvement is present
Coding Notes
- Ensure documentation specifies 'localized' to use R59.0.
D86.1 - Sarcoidosis of lung
Use when sarcoidosis is confirmed and involves the lungs.
Applicable To
- Sarcoidosis with hilar lymphadenopathy
Excludes
- Sarcoidosis without lung involvement (D86.0)
Clinical Validation Requirements
- Biopsy showing non-caseating granulomas
- Elevated ACE levels
Coding Notes
Confirmatory biopsy is crucial for accurate coding.
C78.01 - Secondary malignant neoplasm of right lung
Use when metastasis to right hilar lymph nodes is confirmed.
Applicable To
- Metastatic cancer to right hilar lymph nodes
Excludes
- Primary lung cancer (C34.9)
Clinical Validation Requirements
- Histological confirmation of metastasis
- PET scan showing FDG-avid nodes
Coding Notes
Ensure primary cancer is coded first.
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 Hilar Lymphadenopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R59.0.
Impact
Clinical: May lead to misinterpretation of clinical severity., Regulatory: Non-compliance with specificity requirements., Financial: Potential denial of claims due to lack of specificity.
Mitigation Strategy
Ensure documentation specifies location and extent., Use imaging to confirm diagnosis.
Impact
Reimbursement: Potential underpayment due to incorrect coding., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies 'localized' hilar lymphadenopathy.
Impact
Audits may target cases where lymphadenopathy is not clearly documented as localized or generalized.
Mitigation Strategy
Ensure all documentation includes specific location and extent of lymphadenopathy.
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 Lymphadenopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hilar Lymphadenopathy
Use these documentation templates to ensure complete and accurate documentation for Hilar Lymphadenopathy. These templates include all required elements for proper coding and billing.
Pulmonary Sarcoidosis with Hilar Lymphadenopathy
Specialty: PulmonologyRequired Elements
- Patient history
- Imaging results
- Biopsy findings
- ACE levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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