ICD-10 Coding for Cellulitis of Lower Extremity(L03.116, L03.115)
Complete ICD-10-CM coding and documentation guide for Cellulitis of Lower Extremity. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cellulitis of Lower Extremity
L03.11-L03.119Primary Range
Cellulitis of lower limb, including thigh, leg, ankle, and foot
This range includes all codes for cellulitis affecting the lower extremity, specifying laterality and location.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L03.116 | Cellulitis of left lower limb | Use when cellulitis is confirmed in the left lower limb, with specific documentation of the affected area. |
|
| L03.115 | Cellulitis of right lower limb | Use when cellulitis is confirmed in the right lower limb, with specific documentation of the affected area. |
|
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 of lower extremity
Essential facts and insights about Cellulitis of Lower Extremity
Primary ICD-10-CM Codes for cellulitis of lower extremity
Decision Criteria
clinical Criteria
- Presence of erythema, swelling, and tenderness in the left lower limb
documentation Criteria
- Specific mention of 'left lower limb' in the medical record
Applicable To
- Cellulitis of left thigh
- Cellulitis of left leg
- Cellulitis of left ankle
- Cellulitis of left foot
Excludes
- Abscess of left lower limb (L02.416)
Clinical Validation Requirements
- Erythema and swelling of the left lower limb
- Tenderness and warmth over the affected area
- No abscess formation
Code-Specific Risks
- Incorrect laterality documentation
- Omission of causal organism code
Coding Notes
- Ensure documentation specifies the exact location and laterality of the cellulitis.
L03.115 - Cellulitis of right lower limb
Use when cellulitis is confirmed in the right lower limb, with specific documentation of the affected area.
Applicable To
- Cellulitis of right thigh
- Cellulitis of right leg
- Cellulitis of right ankle
- Cellulitis of right foot
Excludes
- Abscess of right lower limb (L02.415)
Clinical Validation Requirements
- Erythema and swelling of the right lower limb
- Tenderness and warmth over the affected area
- No abscess formation
Coding Notes
Ensure documentation specifies the exact location and laterality of the cellulitis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Staphylococcus infection as the cause of diseases classified elsewhere
B95.8Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Erysipelas
A46Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cellulitis of Lower Extremity to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L03.116.
Impact
Clinical: May affect treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always include organism code if infection is confirmed., Review lab results for organism identification.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data collection and reporting.
Mitigation Strategy
Always document and code the specific side affected (left or right).
Impact
Failure to document laterality can lead to incorrect coding.
Mitigation Strategy
Implement a checklist for documentation review.
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 Lower Extremity, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cellulitis of Lower Extremity
Use these documentation templates to ensure complete and accurate documentation for Cellulitis of Lower Extremity. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Cellulitis
Specialty: Emergency MedicineRequired Elements
- Patient history
- Physical examination findings
- Specific location and laterality
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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