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v1.0.0
ICD-10 Guide
ICD-10 CodesR59

R59

Enlarged lymph nodes

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 R59 is a used to indicate a diagnosis of enlarged lymph nodes.

Key Diagnostic Point:

Enlarged lymph nodes, classified under the ICD-10 code R59, refer to lymphadenopathy that can occur due to a variety of underlying conditions. This category encompasses both localized and generalized lymph node enlargement, which may arise from infections, autoimmune diseases, malignancies, or other pathological processes. Clinically, the presence of enlarged lymph nodes can indicate an immune response to infection or inflammation, and it may warrant further investigation to determine the underlying cause. The significance of this condition lies in its potential to signal serious health issues, thus necessitating appropriate diagnostic measures and interventions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes
  • Need for differential diagnosis
  • Potential for serious conditions

Audit Risk Factors

  • Inconsistent documentation of underlying causes
  • Misuse of codes for non-specific symptoms
  • Failure to provide adequate clinical rationale

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Oncology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related Codes

Child Codes

3 codes
R59.0
Localized enlarged lymph nodes
R59.1
Generalized enlarged lymph nodes
R59.9
Enlarged lymph nodes, unspecified

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of R59 is significant as it serves as a flag for potential underlying health issues that may require further investigation. From a population health perspective, monitoring the incidence of lymphadenopathy can provide insights into trends related to infectious diseases or cancer prevalence in specific demographics. Administratively, accurate coding of R59 can influence quality measures and healthcare outcomes, as it may lead to timely interventions and improved patient management strategies.

ICD-9 vs ICD-10

The clinical impact of R59 is significant as it serves as a flag for potential underlying health issues that may require further investigation. From a population health perspective, monitoring the incidence of lymphadenopathy can provide insights into trends related to infectious diseases or cancer prevalence in specific demographics. Administratively, accurate coding of R59 can influence quality measures and healthcare outcomes, as it may lead to timely interventions and improved patient management strategies.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the case and the payer's policies, so it is crucial to stay updated on billing guidelines and coding updates. Additionally, coding for any related tests or procedures should be aligned with the primary diagnosis to avoid claim denials.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for R59

Coding & Billing References

  • •
    Official ICD-10 Guidelines for R59

Frequently Asked Questions

What conditions are included in R59?

R59 includes conditions such as benign lymphadenopathy, lymph nodes enlarged due to infections (like viral or bacterial), and lymphadenopathy associated with malignancies such as lymphoma or metastatic cancer.

When should I use R59 codes?

R59 codes should be used when a patient presents with enlarged lymph nodes without a specific diagnosis. It is important to document the clinical findings and any relevant history to support the use of this code.

What documentation is required for R59?

Documentation should include a thorough clinical examination, details of the lymph node enlargement (location, size, and duration), and any relevant patient history or symptoms that may indicate the underlying cause.