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ICD-10 Guide
ICD-10 CodesR22.4

R22.4

Localized swelling, mass and lump, lower limb

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

Code Description

ICD-10 R22.4 is a billable code used to indicate a diagnosis of localized swelling, mass and lump, lower limb.

Key Diagnostic Point:

Localized swelling, mass, and lump in the lower limb can present as a palpable or visible enlargement of tissue in the leg or foot. This condition may arise from various underlying causes, including trauma, infection, inflammation, or neoplastic processes. Symptoms may include pain, tenderness, and changes in skin color or temperature. Clinical examination often reveals a firm or soft mass, which may be mobile or fixed to underlying structures. Diagnostic imaging, such as ultrasound or MRI, may be necessary to assess the characteristics of the mass and determine its etiology. Laboratory tests may include blood work to evaluate for infection or inflammatory markers. Accurate diagnosis is crucial, as the differential diagnosis can range from benign conditions like lipomas to malignant tumors. Understanding the clinical context and associated symptoms is essential for appropriate management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes (benign to malignant)
  • Need for thorough clinical documentation to support diagnosis
  • Differential diagnosis may require imaging or lab tests
  • Variability in presentation and symptoms among patients

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the location of the mass
  • Misuse of the code for generalized swelling
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history and physical examination notes, including size, location, and characteristics of the mass.

Common Clinical Scenarios

Patients presenting with a new lump in the leg, often requiring further evaluation for underlying causes.

Billing Considerations

Ensure that any associated symptoms (pain, redness, warmth) are documented to support the diagnosis.

Emergency Medicine

Documentation Requirements

Acute care notes must include the mechanism of injury if trauma is involved, vital signs, and any immediate interventions.

Common Clinical Scenarios

Patients presenting with acute swelling following trauma or infection.

Billing Considerations

Rapid assessment and documentation are critical; ensure that any imaging results are included in the record.

Coding Guidelines

Inclusion Criteria

Use R22.4 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the swelling, mass, or lump is localized to the lower limb and not due to systemic conditions

Exclusion Criteria

Do NOT use R22.4 When
No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits regarding the evaluation of a lower limb mass.

Documentation Requirements

Document the reason for the visit, examination findings, and any treatment plans.

Specialty Considerations

Ensure that the visit is clearly linked to the evaluation of the mass.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of localized conditions, improving the accuracy of data collection and reimbursement processes. R22.4 provides a clear distinction for localized swelling in the lower limb, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of localized conditions, improving the accuracy of data collection and reimbursement processes. R22.4 provides a clear distinction for localized swelling in the lower limb, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. R22.4 provides a clear distinction for localized swelling in the lower limb, which aids in clinical management and research.

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 R22.4?

Documentation should include the size, location, characteristics of the mass, associated symptoms, and any diagnostic tests performed to evaluate the mass.