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R59.0
ICD-10-CM
Hilar Lymphadenopathy

Understanding Hilar Lymphadenopathy: This guide provides essential information for healthcare professionals on hilar lymphadenopathy, including clinical documentation best practices, ICD-10 coding (R59.8), differential diagnosis, associated symptoms (cough, shortness of breath), causes (infection, sarcoidosis, malignancy), radiology findings (enlarged hilar lymph nodes on chest X-ray or CT scan), and treatment considerations. Learn about accurate medical coding and documentation for improved patient care and billing.

Also known as

Hilar Adenopathy
Pulmonary Lymphadenopathy

Diagnosis Snapshot

Key Facts
  • Definition : Enlarged lymph nodes in the hila (roots) of the lungs.
  • Clinical Signs : Often asymptomatic. May cause cough, shortness of breath, or chest pain if large.
  • Common Settings : Infections (TB, fungal), sarcoidosis, lymphoma, lung cancer.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC R59.0 Coding
R59

Enlarged lymph nodes

Covers localized or generalized lymph node enlargement, including hilar.

R69

Unspecified lymphadenopathy

Used when the location or cause of lymphadenopathy is not specified.

J98.89

Other respiratory disorders

May be used for hilar lymphadenopathy associated with respiratory conditions.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is hilar lymphadenopathy due to a specific disease?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Enlarged lymph nodes in the hila
Sarcoidosis
Lymphoma

Documentation Best Practices

Documentation Checklist
  • Hilar lymphadenopathy: laterality (unilateral/bilateral)
  • Size of hilar lymph nodes (mm)
  • Location and distribution of nodes
  • Imaging characteristics (CT, X-ray)
  • Associated symptoms or underlying conditions

Coding and Audit Risks

Common Risks
  • Unspecified Laterality

    Coding lacks laterality (right, left, bilateral) causing claim denials and inaccurate data reporting. CDI can query for clarity.

  • Underlying Cause Missing

    Hilar lymphadenopathy is a symptom. Missing underlying etiology (e.g., infection, malignancy) impacts DRG assignment and quality metrics. CDI crucial.

  • Clinical Validation

    Code assignment must be supported by clinical documentation. Insufficient evidence can lead to audit failures and compliance issues. CDI ensures accurate reflection of findings.

Mitigation Tips

Best Practices
  • Document precise hilar location, size, laterality for accurate ICD-10 coding (R59.8).
  • Correlate lymphadenopathy with clinical findings for improved CDI, HCC coding compliance.
  • Specify if lymphadenopathy is unilateral or bilateral for precise SNOMED CT coding.
  • Thorough imaging review crucial for distinguishing hilar from mediastinal nodes.
  • If cause identified, code etiology, not R59.8, ensuring compliant HCC billing.

Clinical Decision Support

Checklist
  • Confirm enlarged lymph nodes on imaging at hilum (ICD-10 R59.8, R69.8)
  • Exclude infectious causes (TB, sarcoidosis) with appropriate tests
  • Evaluate for malignancy (lung cancer, lymphoma) - consider biopsy
  • Document location, size, characteristics of lymphadenopathy for accurate coding

Reimbursement and Quality Metrics

Impact Summary
  • Hilar Lymphadenopathy Reimbursement: ICD-10 R59.8, CPT varies (imaging, biopsy). Coding accuracy crucial for maximizing reimbursement.
  • Quality Metrics Impact: Accurate hilar lymphadenopathy diagnosis impacts reporting on respiratory disease management and cancer staging.
  • Hospital Reporting: Hilar lymphadenopathy data affects resource allocation, treatment protocols, and patient outcome tracking.
  • Coding Tip: Document laterality (right, left, bilateral) and specify if mediastinal nodes involved for accurate coding and billing.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code R59.8 for unspecified lymphadenopathy
  • Document location 'hilar' clearly
  • Consider laterality codes (R/L)
  • ICD-10-CM R59.8 with site detail
  • Check imaging reports for size/number

Documentation Templates

Patient presents with [signs/symptoms, e.g., cough, shortness of breath, chest pain, fever, weight loss, fatigue] concerning for hilar lymphadenopathy.  Differential diagnosis includes sarcoidosis, lymphoma, tuberculosis, fungal infections, lung cancer, and other mediastinal pathologies.  Physical exam reveals [relevant findings, e.g., clear breath sounds, palpable lymph nodes, etc.].  Imaging studies, including [chest x-ray, CT scan of the chest with contrast, PET scan], demonstrate enlargement of lymph nodes in the hilar region, measuring [size in mm].  Location and characteristics of lymphadenopathy noted as [e.g., bilateral, unilateral, calcified, necrotic].  Pulmonary function tests [performed/not performed], revealing [results if performed].  Laboratory tests ordered include [e.g., complete blood count, comprehensive metabolic panel, angiotensin-converting enzyme, purified protein derivative skin test, fungal serologies].  Preliminary assessment suggests [possible diagnoses].  Further investigation with [e.g., bronchoscopy with biopsy, mediastinoscopy, endobronchial ultrasound] is planned to obtain tissue for histopathological analysis and confirm the etiology of hilar lymphadenopathy.  Patient education provided regarding the potential causes, diagnostic procedures, and treatment options for enlarged hilar lymph nodes.  Follow-up scheduled in [timeframe] to review results and discuss next steps in management.  ICD-10 code [R59.8, other specified enlarged lymph nodes] is provisionally assigned, pending definitive diagnosis.  Medical billing codes will be finalized based on the complete workup and treatment plan.