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v1.0.0
ICD-10 Guide
ICD-10 CodesR22.42

R22.42

Localized swelling, mass and lump, left lower limb

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

Code Description

ICD-10 R22.42 is a billable code used to indicate a diagnosis of localized swelling, mass and lump, left lower limb.

Key Diagnostic Point:

Localized swelling, mass, and lump in the left lower limb can present as a palpable or visible enlargement of tissue in the leg, ankle, or foot. This condition may arise from various underlying causes, including trauma, infection, inflammation, or neoplastic processes. Symptoms may include pain, tenderness, warmth, and changes in skin color or texture. The mass may be soft or firm, mobile or fixed, and can vary in size. Clinical evaluation often involves a thorough history and physical examination, focusing on the duration, progression, and associated symptoms. Imaging studies such as ultrasound, X-ray, or MRI may be warranted to assess the mass's characteristics and guide further management. Laboratory tests may be performed to rule out infection or inflammatory conditions. Accurate diagnosis is crucial, as the underlying cause can range from benign to malignant conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for detailed clinical documentation
  • Differentiation from similar codes
  • Potential for misclassification

Audit Risk Factors

  • Inadequate documentation of the mass characteristics
  • Failure to specify laterality
  • Misdiagnosis leading to incorrect coding
  • Lack of follow-up documentation

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of the mass, including onset, duration, and associated symptoms; physical examination findings; and any diagnostic imaging results.

Common Clinical Scenarios

Patients presenting with unexplained swelling or mass in the left lower limb, often requiring differential diagnosis to rule out serious conditions.

Billing Considerations

Consideration of comorbidities that may affect the diagnosis and management of the swelling.

Emergency Medicine

Documentation Requirements

Acute assessment of the mass, including vital signs, pain assessment, and immediate imaging if indicated.

Common Clinical Scenarios

Patients presenting with acute swelling due to trauma, infection, or vascular issues.

Billing Considerations

Rapid assessment and documentation are critical to ensure appropriate coding and management.

Coding Guidelines

Inclusion Criteria

Use R22.42 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code is used only when the swelling, mass, or lump is localized to the left lower limb and not due to systemic conditions

Exclusion Criteria

Do NOT use R22.42 When
No specific exclusions found.

Related CPT Codes

76942CPT Code

Ultrasound, soft tissue

Clinical Scenario

Used to evaluate the characteristics of the mass in the left lower limb.

Documentation Requirements

Document the reason for the ultrasound and findings.

Specialty Considerations

Ensure the ultrasound is performed by a qualified technician and interpreted by a specialist.

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 diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of localized conditions, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of localized conditions, improving the accuracy of diagnoses and treatment plans.

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 I document to support the use of R22.42?

Document the characteristics of the mass, including size, tenderness, duration, and any associated symptoms. Include imaging results and any differential diagnoses considered.