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v1.0.0
ICD-10 Guide
ICD-10 CodesR59.0

R59.0

Localized enlarged lymph nodes

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

Code Description

ICD-10 R59.0 is a billable code used to indicate a diagnosis of localized enlarged lymph nodes.

Key Diagnostic Point:

Localized enlarged lymph nodes, classified under ICD-10 code R59.0, refer to the swelling of lymph nodes in a specific area of the body, which can be indicative of various underlying conditions. These lymph nodes may become enlarged due to infections, autoimmune diseases, malignancies, or other inflammatory processes. Clinically, patients may present with palpable lymphadenopathy, which can be assessed through physical examination. Symptoms may include tenderness, pain, or discomfort in the affected area, and systemic symptoms such as fever, night sweats, or weight loss may also be present, depending on the underlying cause. Laboratory findings may include elevated white blood cell counts, abnormal lymphocyte profiles, or specific markers indicating infection or malignancy. Accurate diagnosis often requires correlation with clinical history, imaging studies, and possibly biopsy of the lymph node to determine the etiology of the enlargement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (infectious, neoplastic, autoimmune)
  • Need for thorough clinical evaluation and history
  • Potential for misclassification with generalized lymphadenopathy
  • Documentation of associated symptoms and findings

Audit Risk Factors

  • Inadequate documentation of the cause of lymphadenopathy
  • Failure to specify the location of the enlarged lymph nodes
  • Misuse of related codes leading to incorrect coding
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with fever and localized lymphadenopathy, possibly indicating an infection.

Billing Considerations

Consideration of chronic conditions that may lead to persistent lymphadenopathy.

Emergency Medicine

Documentation Requirements

Acute care notes including vital signs, immediate lab results, and any imaging performed.

Common Clinical Scenarios

Acute presentations of lymphadenopathy with systemic symptoms such as fever or rash.

Billing Considerations

Rapid assessment and documentation of potential life-threatening conditions.

Coding Guidelines

Inclusion Criteria

Use R59.0 When
  • Follow official ICD
  • CM guidelines for coding symptoms and signs
  • Ensure that the code is supported by clinical documentation and that the specific location of the lymph nodes is noted

Exclusion Criteria

Do NOT use R59.0 When
No specific exclusions found.

Related CPT Codes

88305CPT Code

Pathology examination of lymph node biopsy

Clinical Scenario

When a lymph node biopsy is performed to evaluate the cause of lymphadenopathy.

Documentation Requirements

Pathology report and clinical notes supporting the need for biopsy.

Specialty Considerations

Oncology may require additional documentation regarding the malignancy workup.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lymphadenopathy, improving the granularity of data for epidemiological studies and clinical research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lymphadenopathy, improving the granularity of data for epidemiological studies and clinical research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of lymphadenopathy, improving the granularity of data for epidemiological studies and clinical 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 R59.0?

Documentation should include the specific location of the enlarged lymph nodes, associated symptoms, clinical findings, and any relevant diagnostic tests performed.