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v1.0.0
ICD-10 Guide
ICD-10 CodesR59.1

R59.1

Generalized enlarged lymph nodes

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

Code Description

ICD-10 R59.1 is a billable code used to indicate a diagnosis of generalized enlarged lymph nodes.

Key Diagnostic Point:

Generalized enlarged lymph nodes, or lymphadenopathy, refers to the enlargement of lymph nodes throughout the body, which can be a sign of various underlying conditions. This condition can manifest as swelling in multiple regions, including the neck, armpits, and groin. The enlargement may be due to infections, autoimmune diseases, malignancies, or other systemic conditions. Symptoms accompanying generalized lymphadenopathy can include fever, night sweats, weight loss, and fatigue, depending on the underlying cause. Clinicians often perform a thorough history and physical examination, alongside laboratory tests such as complete blood counts, imaging studies, and sometimes lymph node biopsy, to determine the etiology of the lymphadenopathy. Accurate diagnosis is crucial, as the treatment and prognosis can vary significantly based on the underlying cause. This code is used when the lymphadenopathy is generalized and not confined to a specific region, indicating a systemic issue rather than a localized infection or malignancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for comprehensive clinical documentation
  • Differentiation from localized lymphadenopathy codes
  • Potential overlap with other ICD codes

Audit Risk Factors

  • Inadequate documentation of the underlying cause
  • Failure to specify the extent of lymphadenopathy
  • Misuse of this code when a more specific diagnosis exists
  • Lack of follow-up documentation for ongoing conditions

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, physical examination findings, and results from laboratory tests and imaging studies.

Common Clinical Scenarios

Patients presenting with unexplained fever, weight loss, and generalized lymphadenopathy requiring further investigation.

Billing Considerations

Consideration of autoimmune disorders and malignancies in differential diagnosis.

Emergency Medicine

Documentation Requirements

Acute care documentation including vital signs, presenting symptoms, and immediate lab results.

Common Clinical Scenarios

Patients with acute infections presenting with fever and generalized lymphadenopathy.

Billing Considerations

Rapid assessment and documentation of potential life-threatening conditions.

Coding Guidelines

Inclusion Criteria

Use R59.1 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code is used only when lymphadenopathy is generalized and not due to a specific localized condition
  • Document the clinical findings and any relevant diagnostic tests performed

Exclusion Criteria

Do NOT use R59.1 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 investigate the cause of generalized lymphadenopathy.

Documentation Requirements

Document the indication for biopsy, findings, and results.

Specialty Considerations

Pathology reports should be linked to the diagnosis of generalized lymphadenopathy.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like generalized lymphadenopathy, improving the granularity of data for epidemiological studies and healthcare analytics.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like generalized lymphadenopathy, improving the granularity of data for epidemiological studies and healthcare analytics.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like generalized lymphadenopathy, improving the granularity of data for epidemiological studies and healthcare analytics.

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 difference between generalized and localized lymphadenopathy?

Generalized lymphadenopathy involves multiple lymph node regions being enlarged, indicating a systemic issue, while localized lymphadenopathy is confined to a specific area, often due to localized infection or malignancy.