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2025 ICD-10-CM code A15.4

Tuberculosis of intrathoracic lymph nodes.

Use additional code to identify resistance to antimicrobial drugs (Z16.-). Exclude certain localized infections (see body system-related chapters), carrier or suspected carrier status (Z22.-), infections complicating pregnancy, childbirth, and the puerperium (O98.-), and perinatal period infections (P35-P39).

Medical necessity is established by confirming active tuberculosis infection affecting the intrathoracic lymph nodes. This is crucial for justifying treatment and interventions to prevent disease progression and transmission.

Physicians diagnose the condition based on the patient’s symptoms, history, and physical examination. They may perform tests such as bronchoscopy, chest X–ray or CT scan, and tuberculin skin test. Laboratory tests of the patient’s sputum can detect the organism. Treatment commonly includes a combination of isoniazid, rifampin, ethambutol, and pyrazinamide for six months or longer, often using directly observed therapy (DOT). Surgery to remove infected lymph nodes is also a possibility.

In simple words: Tuberculosis (TB) can infect the lymph nodes in your chest. This is more common in younger people as a first-time infection, but older people can get it too. It can cause fever, tiredness, trouble breathing, and weight loss. Doctors diagnose it with tests and scans.

This condition refers to tuberculosis affecting the lymph nodes within the thorax, including hilar, mediastinal, and tracheobronchial lymph nodes. It often manifests as a primary infection, particularly in children, teenagers, and young adults, but can also occur as a secondary manifestation in older adults. Symptoms can vary but may include fever, loss of appetite, difficulty breathing, fatigue, weight loss, night sweats, and general health decline. Diagnosis involves a combination of physical examination, medical history, imaging studies (chest X-ray, CT scan), and laboratory tests.

Example 1: A 10-year-old child presents with persistent cough, fever, and weight loss. Imaging reveals enlarged intrathoracic lymph nodes, and sputum cultures confirm Mycobacterium tuberculosis., A 65-year-old individual with a history of TB experiences recurrent respiratory issues. A CT scan shows mediastinal lymphadenopathy, consistent with reactivation of latent TB infection., A 25-year-old individual undergoing routine chest X-ray shows hilar lymphadenopathy. Further investigation, including biopsy and culture, confirms A15.4.

Documentation should include evidence of infection with Mycobacterium tuberculosis, imaging findings of intrathoracic lymph node involvement, clinical presentation (symptoms, physical exam), and results of diagnostic tests (e.g., sputum culture, biopsy).

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