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ICD-10 Guide
ICD-10 CodesL03.042

L03.042

Billable

Acute lymphangitis of left toe

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

Code Description

ICD-10 L03.042 is a billable code used to indicate a diagnosis of acute lymphangitis of left toe.

Key Diagnostic Point:

Acute lymphangitis of the left toe is an inflammatory condition characterized by the infection of the lymphatic vessels, typically resulting from a bacterial infection that ascends from a localized skin infection, such as cellulitis or an infected wound. Clinically, patients may present with symptoms including redness, swelling, and pain along the affected lymphatic pathways, often accompanied by systemic signs such as fever and malaise. The anatomy involved primarily includes the lymphatic vessels of the lower extremity, particularly those draining the toe. Disease progression can lead to severe complications if left untreated, including systemic infection or sepsis. Diagnostic considerations include a thorough clinical examination, patient history, and possibly imaging studies to assess the extent of lymphatic involvement. Laboratory tests may also be performed to identify the causative organism and guide antibiotic therapy. Prompt recognition and treatment are essential to prevent complications and promote recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging to confirm lymphangitis.
  • Treatment complexity: Involves antibiotic therapy and monitoring for complications.
  • Documentation requirements: Detailed documentation of symptoms, treatment response, and follow-up care is necessary.
  • Coding specificity: Requires accurate coding to differentiate from other skin and soft tissue infections.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected limb or misclassification of the condition.
  • Documentation gaps: Incomplete records regarding the onset, treatment, and follow-up can lead to denials.
  • Billing challenges: Potential for denials if the link between the infection and the lymphangitis is not clearly documented.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Acute lymphangitis can significantly impact patient health, leading to increased healthcare utilization due to potential complications such as sepsis. Understanding the epidemiology of this condition is crucial, as it can affect various populations, particularly those with compromised immune systems or chronic skin conditions. Quality measures should focus on timely diagnosis and effective treatment to reduce the incidence of severe outcomes.

ICD-9 vs ICD-10

Acute lymphangitis can significantly impact patient health, leading to increased healthcare utilization due to potential complications such as sepsis. Understanding the epidemiology of this condition is crucial, as it can affect various populations, particularly those with compromised immune systems or chronic skin conditions. Quality measures should focus on timely diagnosis and effective treatment to reduce the incidence of severe outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear linkage between the clinical findings and the diagnosis of acute lymphangitis. Common denials may arise from insufficient documentation of the infection's severity or the absence of a treatment plan. Best practices include maintaining thorough records of patient encounters, treatment responses, and follow-up care to support the medical necessity of the services provided.

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 L03.042?

L03.042 specifically covers acute lymphangitis affecting the left toe, which may arise from localized infections such as cellulitis, abscesses, or other skin infections that lead to lymphatic involvement.

When should L03.042 be used instead of related codes?

L03.042 should be used when the clinical presentation specifically involves acute lymphangitis of the left toe, differentiating it from other sites or types of lymphangitis, such as those affecting the right toe or other extremities.

What documentation supports L03.042?

Documentation should include clinical findings such as the presence of erythema, swelling, and tenderness along the lymphatic vessels, as well as any laboratory results confirming infection and treatment plans that detail the management of the condition.