ICD-10 Guide

R68.3

Clubbing of fingers

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/11/2025

Code Description

ICD-10 R68.3 is a billable code used to indicate a diagnosis of clubbing of fingers.

Key Diagnostic Point:

Clubbing of fingers is a clinical sign characterized by the enlargement of the distal phalanges of the fingers and toes, leading to a bulbous appearance. This condition is often associated with various underlying diseases, particularly those affecting the lungs, heart, and gastrointestinal tract. The pathophysiology of clubbing is not entirely understood, but it is believed to involve increased blood flow to the distal digits and changes in the connective tissue. Common causes include chronic lung diseases such as cystic fibrosis, interstitial lung disease, and lung cancer, as well as congenital heart defects and inflammatory bowel diseases. The presence of clubbing can indicate a chronic hypoxic state or systemic disease, making it a significant finding during physical examinations. Diagnosis typically involves a thorough clinical history, physical examination, and may require imaging studies or laboratory tests to identify the underlying cause. Accurate documentation of clubbing, including its onset, associated symptoms, and any relevant medical history, is crucial for proper coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of underlying conditions that can cause clubbing
Need for thorough clinical documentation to support diagnosis
Potential for misclassification with other finger abnormalities
Variability in clinical presentation among patients

Audit Risk Factors

Inadequate documentation of the underlying cause of clubbing
Failure to link clubbing to a primary diagnosis
Misinterpretation of clubbing as a standalone diagnosis
Lack of follow-up documentation in chronic cases

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of respiratory or cardiovascular symptoms, physical examination findings, and any relevant diagnostic tests.

Common Clinical Scenarios

Patients presenting with chronic cough, dyspnea, or unexplained weight loss.

Billing Considerations

Consideration of comorbidities and their potential contribution to clubbing.

Emergency Medicine

Documentation Requirements

Acute assessment of clubbing in the context of respiratory distress or acute illness.

Common Clinical Scenarios

Patients with sudden onset of respiratory symptoms or acute exacerbation of chronic lung disease.

Billing Considerations

Rapid assessment and documentation of clubbing in emergency settings to guide immediate management.

Coding Guidelines

Inclusion Criteria

Use R68.3 When

Follow official ICD
CM coding guidelines, ensuring that clubbing is documented as a symptom and linked to the underlying condition when applicable
Use additional codes to specify the underlying cause if known

Exclusion Criteria

Do NOT use R68.3 When

No specific exclusions found.

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used when evaluating a patient with clubbing during a routine follow-up visit.

Documentation Requirements

Document the patient's history, examination findings, and any relevant diagnostic tests.

Specialty Considerations

Internal medicine specialists should ensure comprehensive documentation of clubbing and its implications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of symptoms like clubbing, improving the ability to capture the complexity of patient presentations and their underlying causes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of symptoms like clubbing, improving the ability to capture the complexity of patient presentations and their underlying causes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of symptoms like clubbing, improving the ability to capture the complexity of patient presentations and their underlying causes.

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 is the primary cause of clubbing?

Clubbing can be caused by various conditions, primarily those affecting the lungs, heart, and gastrointestinal tract. Chronic hypoxia is a common underlying mechanism.

How should clubbing be documented in the medical record?

Clubbing should be documented with details about its onset, associated symptoms, and any relevant medical history to support accurate coding.

ICD-10 R68.3 is a billable code used to indicate a diagnosis of clubbing of fingers.