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2025 ICD-10-CM code L03.11

Cellulitis of other parts of the limb.

Appropriate coding requires precise documentation of the location and extent of cellulitis to ensure correct code assignment.Exclusions should be carefully considered to prevent miscoding.Use of additional codes (B95-B97) for infectious agents is recommended.

Modifiers may apply depending on the circumstances of the encounter (e.g., place of service modifiers). Consult the appropriate payer guidelines.

Medical necessity for treatment of cellulitis is established by the presence of clinical signs and symptoms consistent with a bacterial skin infection, often requiring antibiotic therapy to prevent complications such as sepsis or abscess formation. Documentation of these findings is crucial to support medical necessity.

Diagnosis and treatment of cellulitis by a physician, usually involving assessment, ordering labs (blood cultures, etc.), prescribing antibiotics, and monitoring the patient's response to treatment.

IMPORTANT:Use additional code (B95-B97) to identify the infectious agent.Consider codes for specific locations if applicable (e.g., L03.01 for finger cellulitis, L03.03 for toe cellulitis).

In simple words: A bacterial skin infection (cellulitis) affecting an area of the arm or leg other than the fingers, toes, or groin.

Cellulitis of other parts of the limb, excluding cellulitis of fingers (L03.01-), toes (L03.03-), groin (L03.314), anal and rectal region (K61.-), external auditory canal (H60.1), eyelid (H00.0), female external genital organs (N76.4), lacrimal apparatus (H04.3), male external genital organs (N48.2, N49.-), mouth (K12.2), nose (J34.0), eosinophilic cellulitis [Wells] (L98.3), febrile neutrophilic dermatosis [Sweet] (L98.2), chronic/subacute lymphangitis (I89.1).

Example 1: A 60-year-old male presents with erythema, swelling, and pain in his lower leg after a minor injury.A physician diagnoses cellulitis of the lower leg and initiates antibiotic therapy., A 25-year-old female with a history of eczema develops cellulitis in her upper arm. The physician orders blood tests to identify the causative organism and prescribes a course of antibiotics. , An 80-year-old patient with diabetes develops cellulitis on their forearm following a fall.The physician admits the patient to the hospital for intravenous antibiotic treatment and close monitoring for complications.

** L03.11 is a broad code; more specific codes may be used if the location of cellulitis is more precisely defined.Always consult the latest ICD-10-CM guidelines for accurate coding.

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