ICD Code R19.09

ICD code R19.09 is used to classify and document cases where a patient presents with an unspecified swelling, mass, or lump located within the intra-abdominal or pelvic regions. This code is utilized when the specific cause of the swelling or mass is not identified, allowing healthcare providers to accurately record and communicate the condition for billing and treatment purposes.

When considering the use of the ICD code for "Other intra-abdominal and pelvic swelling, mass and lump," healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Presence of a Palpable Mass: Identification of a mass or lump during a physical examination that is located within the abdominal or pelvic region.

2. Patient-Reported Swelling: Reports from the patient of noticeable swelling in the abdominal or pelvic area, which may or may not be accompanied by discomfort.

3. Imaging Findings: Confirmation of an intra-abdominal or pelvic mass through imaging studies such as ultrasound, CT scan, or MRI, which do not clearly indicate a specific diagnosis.

4. Exclusion of Common Conditions: Ruling out more common conditions that could cause similar symptoms, such as hernias, cysts, or tumors with a definitive diagnosis.

5. Non-Specific Symptoms: Presence of non-specific symptoms such as abdominal pain, bloating, or changes in bowel habits that accompany the swelling or mass, without a clear etiology.

6. Unresolved Symptoms: Persistence of symptoms despite initial treatment or observation, warranting further investigation or monitoring.

7. Referral for Specialist Evaluation: Consideration for referral to a specialist, such as a gastroenterologist or gynecologist, for further evaluation and management of the swelling or mass.

By adhering to these criteria, healthcare providers can ensure the appropriate use of the ICD code for documenting and managing cases of intra-abdominal and pelvic swelling, mass, and lump.

For the ICD code R19.09, which pertains to other intra-abdominal and pelvic swelling, mass, and lump, the relevant CPT codes that may be applicable for treatment or diagnostic procedures include:

1. CPT 76700 - Ultrasound, abdominal, real-time with image documentation; complete.

2. CPT 76705 - Ultrasound, abdominal, real-time with image documentation; limited (e.g., single organ, quadrant, follow-up).

3. CPT 74150 - Computed tomography, abdomen; without contrast material.

4. CPT 74160 - Computed tomography, abdomen; with contrast material(s).

5. CPT 74170 - Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections.

6. CPT 49000 - Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure).

7. CPT 49320 - Laparoscopy, surgical; with biopsy (single or multiple).

8. CPT 49400 - Injection of air or contrast into peritoneal cavity (separate procedure).

These CPT codes are typically used for diagnostic imaging and exploratory procedures to assess and manage conditions related to intra-abdominal and pelvic masses or lumps. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical context.

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