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v1.0.0
ICD-10 Guide
ICD-10 CodesR22.33

R22.33

Localized swelling, mass and lump, upper limb, bilateral

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

Code Description

ICD-10 R22.33 is a billable code used to indicate a diagnosis of localized swelling, mass and lump, upper limb, bilateral.

Key Diagnostic Point:

Localized swelling, mass, and lump in the upper limb, bilateral, refers to the presence of abnormal tissue growth or fluid accumulation in both arms. This condition can manifest as a palpable mass or lump, which may vary in size and consistency. Symptoms may include tenderness, pain, or limited range of motion in the affected limbs. The swelling can be due to various underlying causes, including infections, inflammatory conditions, benign tumors, or malignancies. Clinical evaluation often involves a thorough history and physical examination, imaging studies such as ultrasound or MRI, and possibly laboratory tests to identify any infectious or inflammatory processes. Accurate diagnosis is crucial, as the management and treatment will depend on the underlying etiology of the swelling or mass.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for thorough clinical evaluation
  • Differentiation from other similar conditions
  • Potential for overlapping symptoms with other diagnoses

Audit Risk Factors

  • Insufficient documentation of bilateral involvement
  • Lack of clarity on the underlying cause of swelling
  • Inconsistent coding of related conditions
  • Failure to document associated symptoms

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of present illness, physical examination findings, and any relevant lab or imaging results.

Common Clinical Scenarios

Patients presenting with bilateral arm swelling due to conditions like rheumatoid arthritis or systemic lupus erythematosus.

Billing Considerations

Ensure that the documentation clearly states the bilateral nature of the condition and any associated systemic symptoms.

Emergency Medicine

Documentation Requirements

Acute care documentation including vital signs, immediate assessment findings, and any interventions performed.

Common Clinical Scenarios

Patients presenting with acute bilateral swelling due to trauma, infection, or allergic reactions.

Billing Considerations

Document the timeline of symptoms and any immediate treatments administered to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use R22.33 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the bilateral nature of the condition is clearly documented
  • Use additional codes to specify the underlying cause when applicable

Exclusion Criteria

Do NOT use R22.33 When
No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for patients with bilateral swelling.

Documentation Requirements

Document the patient's history, examination findings, and any treatment plans.

Specialty Considerations

Ensure that the visit is clearly linked to the diagnosis of R22.33.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like R22.33, improving the granularity of data collection and enhancing the ability to track and manage patient outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like R22.33, improving the granularity of data collection and enhancing the ability to track and manage patient outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like R22.33, improving the granularity of data collection and enhancing the ability to track and manage patient outcomes.

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

What should be documented to support the use of R22.33?

Documentation should include a detailed description of the swelling, its bilateral nature, associated symptoms, and any diagnostic tests performed to determine the underlying cause.