ICD-10 Coding for Swollen Lymph Nodes(R59.0, R59.1, R59.9)
Complete ICD-10-CM coding and documentation guide for Swollen Lymph Nodes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Swollen Lymph Nodes
R59Primary Range
Enlarged lymph nodes
This range covers the primary codes for documenting swollen lymph nodes, including localized, generalized, and unspecified lymphadenopathy.
Acute lymphadenitis
This range is used when lymphadenopathy is due to an acute infection, requiring different coding.
Malignant neoplasms of lymphoid, hematopoietic and related tissue
This range is relevant when lymphadenopathy is associated with malignancies such as lymphoma.
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 localized to a single site and the cause is unknown. |
|
| R59.1 | Generalized enlarged lymph nodes | Use for systemic conditions affecting multiple lymph node regions. |
|
| R59.9 | Enlarged lymph nodes, unspecified | Use only when documentation does not specify location or characteristics. |
|
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 swollen lymph nodes
Essential facts and insights about Swollen Lymph Nodes
Primary ICD-10-CM Codes for swollen lymph node
Decision Criteria
clinical Criteria
- Node size >1 cm and localized to one region
documentation Criteria
- Documentation specifies location and characteristics
Applicable To
- Localized lymphadenopathy
Clinical Validation Requirements
- Palpable node(s) in one region with size >1 cm (adults) or >2 cm (inguinal)
- Non-tender, mobile nodes
Code-Specific Risks
- Incorrectly using R59.9 when localization is documented.
Coding Notes
- Ensure documentation specifies the location and characteristics of the lymph nodes.
R59.1 - Generalized enlarged lymph nodes
Use for systemic conditions affecting multiple lymph node regions.
Applicable To
- Generalized lymphadenopathy
Excludes
- Acute lymphadenitis (L04.-)
- Chronic lymphadenitis (I88.1)
Clinical Validation Requirements
- Nodes in multiple non-contiguous regions
- Associated symptoms like fever or night sweats
Coding Notes
Document all regions involved and any systemic symptoms.
R59.9 - Enlarged lymph nodes, unspecified
Use only when documentation does not specify location or characteristics.
Applicable To
- Unspecified lymphadenopathy
Excludes
- Acute lymphadenitis (L04.-)
- Chronic lymphadenitis (I88.1)
Clinical Validation Requirements
- Lack of specific localization or characteristics in documentation
Coding Notes
Avoid using unless absolutely necessary due to lack of specificity.
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 Swollen Lymph Nodes 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 misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Train staff on documentation requirements., Use templates to ensure completeness.
Impact
Reimbursement: May lead to claim denials due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies location and characteristics to use R59.0 or R59.1.
Impact
Using unspecified codes when specific codes are applicable.
Mitigation Strategy
Ensure thorough 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 Swollen Lymph Nodes, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Swollen Lymph Nodes
Use these documentation templates to ensure complete and accurate documentation for Swollen Lymph Nodes. These templates include all required elements for proper coding and billing.
Primary Care Examination
Specialty: Primary CareRequired Elements
- Location of lymph nodes
- Size and consistency
- Tenderness and mobility
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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