2025 ICD-10-CM code L03.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Infections of the skin and subcutaneous tissue - Cellulitis Diseases of the skin and subcutaneous tissue (L00-L99) Feed
Cellulitis and acute lymphangitis of other parts of limb.
Modifiers may be applicable depending on the circumstances of service.Consult the appropriate payer guidelines.
Medical necessity is established by the presence of signs and symptoms consistent with cellulitis, which pose a threat to patient health if untreated. This may include rapid spread of infection, presence of fever, or immunocompromised status.
Diagnosis and treatment of cellulitis, including ordering of cultures, antibiotics, and wound care.May involve consultation with specialists like infectious disease doctors or surgeons depending on severity and complications.
In simple words: This code describes a skin infection called cellulitis, affecting an arm or leg (but not the fingers, toes, face, or torso). Cellulitis causes redness, swelling, pain, and warmth in the affected area. Sometimes, the lymphatic vessels (part of the immune system) also become inflamed.
This code represents cellulitis and acute lymphangitis affecting parts of the limb other than fingers and toes, face, or trunk.It includes inflammation of the skin and subcutaneous tissue caused by bacterial infection, often presenting with redness, swelling, pain, and warmth. Acute lymphangitis, the inflammation of lymphatic vessels, frequently accompanies cellulitis.
Example 1: A 60-year-old male presents with a swollen, red, and painful lower leg.Physical examination reveals local warmth and tenderness.Diagnosis of cellulitis of the lower limb (L03.11) is made.Blood cultures are negative, but a wound culture reveals Group A streptococcus.Treatment with intravenous antibiotics is initiated., A 25-year-old female sustains a minor laceration to her forearm during a fall.Three days later, she develops pain, swelling, and erythema along the area of the laceration.A diagnosis of cellulitis of the upper limb (L03.10) is given and is treated with oral antibiotics., A 78-year-old diabetic patient develops a rapidly spreading area of cellulitis on her lower leg, accompanied by fever and chills. This is more severe and needs intravenous antibiotics and close monitoring for possible complications such as sepsis.Diagnosis is L03.11.
Complete history and physical examination, documentation of signs and symptoms (e.g., erythema, edema, pain, warmth), results of any cultures (wound and blood), and details of the treatment plan (e.g., antibiotics, wound care).
** This code excludes cellulitis of specific anatomical locations that have their own distinct codes (e.g., cellulitis of the eyelid, face, fingers, toes, etc.).
- Revenue Code: Revenue codes will vary depending on the specific services provided and the payer.
- RVU: RVUs are not applicable to ICD-10 codes.Reimbursement is determined by the procedures performed and the payer's fee schedule.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Infectious disease, general surgery, dermatology, family medicine
- Place of Service:Office, hospital inpatient, hospital outpatient, urgent care, emergency room