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v1.0.0
ICD-10 Guide
ICD-10 CodesR19.0

R19.0

Intra-abdominal and pelvic swelling, mass and lump

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R19.0 is a billable code used to indicate a diagnosis of intra-abdominal and pelvic swelling, mass and lump.

Key Diagnostic Point:

R19.0 refers to the clinical presentation of intra-abdominal and pelvic swelling, mass, or lump that is not classified elsewhere. This code encompasses a variety of conditions that may present as palpable masses or swelling in the abdominal or pelvic regions. Common symptoms associated with this code include abdominal pain, discomfort, changes in bowel habits, and urinary symptoms, depending on the underlying cause. The swelling may be due to benign conditions such as cysts, lipomas, or organomegaly, or it may indicate more serious pathologies such as tumors, abscesses, or hematomas. Clinical evaluation often involves physical examination, imaging studies (such as ultrasound, CT, or MRI), and laboratory tests to determine the nature of the mass and guide further management. Accurate coding requires thorough documentation of the clinical findings and any diagnostic workup performed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for comprehensive documentation
  • Differentiation from similar codes
  • Potential for overlapping symptoms with other conditions

Audit Risk Factors

  • Insufficient documentation of clinical findings
  • Failure to specify the location of the mass
  • Inadequate differentiation from other abdominal/pelvic codes
  • Lack of follow-up documentation for diagnosed conditions

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history and physical examination findings, imaging results, and any laboratory tests performed.

Common Clinical Scenarios

Patients presenting with abdominal pain and a palpable mass during a routine examination.

Billing Considerations

Ensure to document the size, location, and characteristics of the mass, as well as any associated symptoms.

Emergency Medicine

Documentation Requirements

Acute care documentation including vital signs, immediate findings, and any imaging or lab results obtained in the emergency setting.

Common Clinical Scenarios

Patients presenting with acute abdominal pain and a suspected intra-abdominal mass requiring urgent evaluation.

Billing Considerations

Document the urgency of the situation and any interventions performed, as well as the rationale for imaging studies.

Coding Guidelines

Inclusion Criteria

Use R19.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the swelling, mass, or lump is not classified elsewhere
  • Document the clinical findings and any diagnostic tests performed to support the use of this code

Exclusion Criteria

Do NOT use R19.0 When
No specific exclusions found.

Related CPT Codes

74176CPT Code

CT abdomen and pelvis with contrast

Clinical Scenario

Used when imaging is required to evaluate the mass.

Documentation Requirements

Document the reason for the imaging and findings.

Specialty Considerations

Ensure imaging results are linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of symptoms and signs, including intra-abdominal and pelvic masses, improving the granularity of data for clinical and billing purposes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of symptoms and signs, including intra-abdominal and pelvic masses, improving the granularity of data for clinical and billing purposes.

Reimbursement & Billing Impact

billing purposes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

When should I use R19.0?

Use R19.0 when a patient presents with intra-abdominal or pelvic swelling, mass, or lump that is not classified elsewhere, ensuring that all clinical findings and diagnostic workup are well documented.