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ICD-10 Guide
ICD-10 CodesL03.011

L03.011

Billable

Cellulitis of right finger

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 L03.011 is a billable code used to indicate a diagnosis of cellulitis of right finger.

Key Diagnostic Point:

Cellulitis of the right finger is an acute bacterial infection of the skin and subcutaneous tissues, characterized by redness, swelling, warmth, and pain in the affected area. The condition typically arises from breaks in the skin, such as cuts, insect bites, or surgical wounds, allowing bacteria, most commonly Streptococcus and Staphylococcus species, to invade the tissue. Clinically, patients may present with localized symptoms including erythema, edema, and tenderness, often accompanied by systemic signs like fever and malaise. The anatomy involved includes the dermis and subcutaneous fat layers of the finger, which can lead to complications if not treated promptly. Disease progression can result in abscess formation or systemic spread of infection, necessitating timely diagnosis and intervention. Diagnostic considerations include a thorough clinical examination, patient history, and, in some cases, imaging studies to rule out deeper infections or abscesses. Laboratory tests may also be performed to identify the causative organism and assess the severity of the infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes imaging.
  • Treatment complexity: May involve antibiotics and, in severe cases, surgical intervention.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential.
  • Coding specificity: Specific to the site of infection, necessitating accurate coding.

Audit Risk Factors

  • Common coding errors: Misidentifying the site of infection or using a non-specific code.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Denials may arise from insufficient documentation or incorrect coding.

Specialty Focus

Medical Specialties

Primary medical specialty: Dermatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Infectious Disease

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cellulitis of the right finger, while localized, can have significant clinical implications if not treated promptly, potentially leading to systemic infection or complications. It is important for healthcare providers to recognize and manage this condition effectively to reduce healthcare utilization and improve patient outcomes. Epidemiologically, cellulitis is a common condition that affects various populations, particularly those with compromised skin integrity or underlying health conditions.

ICD-9 vs ICD-10

Cellulitis of the right finger, while localized, can have significant clinical implications if not treated promptly, potentially leading to systemic infection or complications. It is important for healthcare providers to recognize and manage this condition effectively to reduce healthcare utilization and improve patient outcomes. Epidemiologically, cellulitis is a common condition that affects various populations, particularly those with compromised skin integrity or underlying health conditions.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the infection and the treatment provided. Common denials may occur if documentation does not clearly support the diagnosis or if the code is not specific to the site of infection. Best practices include ensuring thorough documentation of the clinical findings, treatment plans, and any follow-up care provided to support the medical necessity of the services billed.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by L03.011?

L03.011 specifically covers cellulitis localized to the right finger, which may arise from trauma, insect bites, or other skin breaches leading to bacterial infection. It does not cover cellulitis of other body parts or infections caused by non-bacterial pathogens.

When should L03.011 be used instead of related codes?

L03.011 should be used when the infection is specifically localized to the right finger. If the infection involves other areas or is of a different nature (e.g., abscess), other codes should be considered, such as L03.012 for the left finger or L03.019 for unspecified fingers.

What documentation supports L03.011?

Documentation should include a detailed clinical assessment of the affected finger, including the onset of symptoms, any history of trauma, and the presence of systemic symptoms. Treatment plans, including prescribed antibiotics and follow-up care, should also be documented.