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I89.0
ICD-10-CM
Lymphedema

Find comprehensive information on lymphedema diagnosis, including ICD-10 codes (I97.2, I89.0), staging (stage 0, stage 1, stage 2, stage 3), symptoms (swelling, limb pain), treatment (manual lymphatic drainage, compression therapy), and clinical documentation best practices. Learn about differential diagnosis, lymphatic system anatomy, and medical coding for lymphedema to improve patient care and healthcare documentation accuracy. This resource covers primary and secondary lymphedema, post-mastectomy lymphedema, and the role of lymphoscintigraphy in diagnosis.

Also known as

Lymphatic Edema
Lymphoedema

Diagnosis Snapshot

Key Facts
  • Definition : Swelling due to impaired lymphatic drainage, often in arms or legs.
  • Clinical Signs : Swelling, tightness, heaviness, restricted range of motion, recurrent infections.
  • Common Settings : Cancer treatment (surgery, radiation), infection, genetic predisposition, trauma.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC I89.0 Coding
I89

Noninfective disorders lymphatic vessels

Covers lymphedema, excluding those of infective origin.

I97

Postprocedural lymphatic disorders, NEC

Lymphedema following a procedure, not elsewhere classified.

R60

Edema, not elsewhere classified

Generalized edema or swelling when the cause is unknown or not specified.

L00-L99

Diseases of the skin and subcut tiss

May include skin changes related to chronic lymphedema.

Code-Specific Guidance

Decision Tree for

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

Is the lymphedema primary (hereditary/congenital)?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Swelling due to lymphatic system blockage.
Swelling due to venous insufficiency.
Swelling due to heart failure.

Documentation Best Practices

Documentation Checklist
  • Lymphedema diagnosis documentation checklist
  • ICD-10 code I89.0, I89.1, I89.8, I89.9 for lymphedema
  • Document location (e.g., arm, leg)
  • Severity (mild, moderate, severe)
  • Stemmer sign positive or negative
  • Underlying cause if known (e.g., surgery, cancer)

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Missing or incorrect laterality (right, left, bilateral) for lymphedema diagnosis impacts accurate coding and reimbursement.

  • Primary vs. Secondary

    Failing to distinguish between primary (congenital) and secondary (acquired) lymphedema leads to inaccurate code assignment and data analysis.

  • Stage Specificity

    Lack of documentation specifying the stage of lymphedema (e.g., latency, stage I, II, III) hinders proper code selection and severity reflection.

Mitigation Tips

Best Practices
  • Early diagnosis: ICD-10 I97.2, I89.0, complete extremity exam
  • Accurate staging: Stage 0-III, impact care plan, measure limb
  • Compression therapy: M79.1, proper fit crucial, patient education
  • Exercise: M54.9, prescribed movements, improve lymph flow
  • Skin care: L89, prevent infection, meticulous hygiene, document

Clinical Decision Support

Checklist
  • 1. Unilateral limb swelling: Gradual onset?
  • 2. Stemmer sign positive? Document Stemmer test.
  • 3. Pitting edema (early)? Nonpitting (late)?
  • 4. Exclude DVT: Wells score documented?

Reimbursement and Quality Metrics

Impact Summary
  • Lymphedema reimbursement: ICD-10 coding (I97, I89), CPT (36400-36415) impacts payments. Accurate coding crucial for maximizing claim acceptance, minimizing denials.
  • Quality metrics impact: Lymphedema stage documentation (e.g., bioimpedance) affects severity reporting, influencing hospital quality scores and patient outcomes.
  • Coding accuracy vital for proper DRG assignment, impacting hospital case-mix index (CMI) and overall financial performance.
  • Complete documentation of lymphedema etiology (primary, secondary) ensures correct reporting, improves data analysis for research and resource allocation.

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 primary lymphedema site
  • Stage impacts coding
  • Laterality is key for I89
  • External cause codes if applicable
  • Document lymphedema etiology

Documentation Templates

Patient presents with complaints consistent with lymphedema.  Symptoms include swelling, tightness, and heaviness in the affected limb,  specifically the [right/left] [upper/lower] extremity.  Onset of symptoms was [gradual/sudden] and began approximately [duration] ago.  Patient reports [presence/absence] of pain, described as [character of pain].  Associated symptoms include [list associated symptoms, e.g., skin changes, reduced range of motion, recurrent infections].  Physical examination reveals [objective findings, e.g., non-pitting edema, Stemmer's sign positive/negative, skin thickening, fibrotic changes].  Measurements of limb circumference demonstrate a difference of [measurement] cm compared to the contralateral limb.  Patient's medical history includes [relevant medical history, e.g., history of cancer, surgery, radiation therapy, infection].  Differential diagnosis includes chronic venous insufficiency, lipedema, and deep vein thrombosis.  Based on the patient's presentation and clinical findings, the diagnosis of lymphedema is made.  Initial treatment plan includes complete decongestive therapy (CDT) consisting of manual lymphatic drainage (MLD), compression bandaging, exercises, and skin care.  Patient education provided regarding self-MLD techniques, compression garment fitting, and risk reduction for cellulitis.  Referral to a certified lymphedema therapist is recommended.  Follow-up appointment scheduled in [duration] to assess treatment response and adjust plan as needed.  ICD-10 code I97.2 (Lymphedema, unspecified) is assigned.  Further diagnostic testing may be considered if deemed necessary.