ICD-10 Coding for Cellulitis of the Foot(L03.115, L03.116, E11.628)
Complete ICD-10-CM coding and documentation guide for Cellulitis of the Foot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cellulitis of the Foot
L03.11-L03.12Primary Range
Cellulitis of the foot
This range covers cellulitis specifically affecting the foot, including laterality.
Type 2 diabetes mellitus with specified complications
Relevant when cellulitis is a complication of diabetes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L03.115 | Cellulitis of right foot | Use when cellulitis is confirmed on the right foot. |
|
| L03.116 | Cellulitis of left foot | Use when cellulitis is confirmed on the left foot. |
|
| E11.628 | Type 2 diabetes mellitus with other skin complications | Use when cellulitis is explicitly documented as a complication of diabetes. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for cellulitis foot
Essential facts and insights about Cellulitis of the Foot
Primary ICD-10-CM Codes for cellulitis foot
Decision Criteria
clinical Criteria
- Presence of erythema and swelling on the right foot
Applicable To
- Right foot cellulitis
- Right ankle cellulitis
Excludes
- Cellulitis of other parts of the leg
Clinical Validation Requirements
- Erythema, warmth, and swelling localized to the right foot
- Positive wound culture
Code-Specific Risks
- Incorrect laterality documentation
Coding Notes
- Ensure laterality is documented clearly.
L03.116 - Cellulitis of left foot
Use when cellulitis is confirmed on the left foot.
Applicable To
- Left foot cellulitis
- Left ankle cellulitis
Excludes
- Cellulitis of other parts of the leg
Clinical Validation Requirements
- Erythema, warmth, and swelling localized to the left foot
- Positive wound culture
Coding Notes
Ensure laterality is documented clearly.
E11.628 - Type 2 diabetes mellitus with other skin complications
Use when cellulitis is explicitly documented as a complication of diabetes.
Applicable To
- Diabetic cellulitis
Excludes
- Diabetic foot ulcer without mention of cellulitis
Clinical Validation Requirements
- Documentation linking cellulitis as a complication of diabetes
Coding Notes
Ensure the provider documents the link between diabetes and cellulitis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Staphylococcus aureus as the cause of diseases classified elsewhere
B95.6Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cellulitis of the Foot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L03.115.
Impact
Clinical: Leads to incomplete clinical records., Regulatory: Non-compliance with coding guidelines., Financial: Potential for incorrect billing and reimbursement.
Mitigation Strategy
Always document laterality in clinical notes., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect DRG assignment leading to potential revenue loss., Compliance: Risk of audit failure due to incorrect coding., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure provider explicitly documents the link between diabetes and cellulitis.
Impact
Risk of incorrect coding if cellulitis is assumed to be diabetic without documentation.
Mitigation Strategy
Ensure explicit documentation of the link between diabetes and cellulitis.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Cellulitis of the Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cellulitis of the Foot
Use these documentation templates to ensure complete and accurate documentation for Cellulitis of the Foot. These templates include all required elements for proper coding and billing.
Diabetic patient with foot cellulitis
Specialty: PodiatryRequired Elements
- Patient history
- Clinical findings
- Diabetes management
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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