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v1.0.0
ICD-10 Guide
ICD-10 CodesR53.0

R53.0

Neoplastic (malignant) related fatigue

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

Code Description

ICD-10 R53.0 is a billable code used to indicate a diagnosis of neoplastic (malignant) related fatigue.

Key Diagnostic Point:

Neoplastic (malignant) related fatigue is a debilitating condition often experienced by patients with cancer. This fatigue is distinct from general fatigue as it is primarily associated with the presence of malignant tumors and can significantly impact a patient's quality of life. Symptoms may include persistent tiredness, lack of energy, and a decreased ability to perform daily activities. Patients may also report cognitive impairments, such as difficulty concentrating or memory issues. The fatigue can be exacerbated by factors such as chemotherapy, radiation therapy, pain, anemia, and psychological stress. Clinically, it is essential to differentiate this fatigue from other causes, as it may require specific management strategies tailored to the underlying malignancy and its treatment. Laboratory findings may reveal anemia, electrolyte imbalances, or other abnormalities that contribute to the fatigue. Accurate identification and coding of this condition are crucial for appropriate treatment and resource allocation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between neoplastic fatigue and fatigue from other causes.
  • Need for comprehensive patient history to establish the link to malignancy.
  • Variability in patient presentation and subjective reporting of fatigue.
  • Potential overlap with other ICD-10 codes related to fatigue.

Audit Risk Factors

  • Inadequate documentation linking fatigue specifically to malignancy.
  • Failure to document associated symptoms or contributing factors.
  • Misclassification of fatigue as a general symptom rather than neoplastic-related.
  • Lack of clarity in treatment notes regarding the patient's cancer status.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including cancer diagnosis, treatment regimen, and symptom assessment.

Common Clinical Scenarios

Patients presenting with fatigue during or after cancer treatment.

Billing Considerations

Consideration of comorbid conditions that may contribute to fatigue.

Emergency Medicine

Documentation Requirements

Acute assessment of fatigue in the context of cancer treatment, including vital signs and lab results.

Common Clinical Scenarios

Patients with acute fatigue exacerbation due to treatment side effects.

Billing Considerations

Rapid evaluation of potential complications related to malignancy.

Coding Guidelines

Inclusion Criteria

Use R53.0 When
  • According to ICD
  • 10 guidelines, R53
  • 0 should be used when fatigue is specifically linked to a malignant condition
  • Documentation must clearly establish this connection, and any contributing factors should be noted

Exclusion Criteria

Do NOT use R53.0 When
No specific exclusions found.

Related CPT Codes

99214CPT Code

Established patient office visit, level 4

Clinical Scenario

Used for follow-up visits where fatigue is assessed in the context of cancer treatment.

Documentation Requirements

Document the patient's cancer history, treatment effects, and fatigue assessment.

Specialty Considerations

Internal medicine and oncology practices should ensure comprehensive documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neoplastic-related fatigue, improving the ability to capture the complexity of cancer-related symptoms and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neoplastic-related fatigue, improving the ability to capture the complexity of cancer-related symptoms and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neoplastic-related fatigue, improving the ability to capture the complexity of cancer-related symptoms and their management.

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 documentation is needed to support the use of R53.0?

Documentation should include the patient's cancer diagnosis, treatment history, and a clear description of how the fatigue is related to the malignancy.