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ICD-10 Guide
ICD-10 CodesL03.21

L03.21

Non-billable

Cellulitis and acute lymphangitis of face

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

Code Description

ICD-10 L03.21 is a used to indicate a diagnosis of cellulitis and acute lymphangitis of face.

Key Diagnostic Point:

L03.21 refers to cellulitis and acute lymphangitis of the face, a condition characterized by inflammation of the skin and subcutaneous tissues, often resulting from bacterial infection. Clinically, patients may present with symptoms such as redness, swelling, warmth, and pain localized to the facial area, often accompanied by systemic symptoms like fever and malaise. The anatomy involved includes the dermis and subcutaneous fat, with lymphatic vessels potentially affected, leading to lymphangitis. Disease progression can vary; if untreated, cellulitis may lead to abscess formation or systemic infection. Diagnostic considerations include a thorough clinical examination and may involve imaging studies if complications are suspected. Laboratory tests such as blood cultures may be warranted in severe cases to identify the causative organism. Prompt diagnosis and treatment are crucial to prevent complications and ensure optimal patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes imaging to rule out other conditions.
  • Treatment complexity: May involve antibiotics, and in some cases, surgical intervention for abscess drainage.
  • Documentation requirements: Detailed documentation of symptoms, treatment response, and follow-up is necessary.
  • Coding specificity: Requires precise coding to differentiate from other skin infections.

Audit Risk Factors

  • Common coding errors: Misidentifying the site of infection or failing to document associated symptoms.
  • Documentation gaps: Incomplete records regarding the extent of the infection or treatment provided.
  • Billing challenges: Potential denials if documentation does not support the severity or specificity of the condition.

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

The clinical significance of L03.21 lies in its potential to lead to serious complications if not treated promptly, including systemic infection or abscess formation. In terms of population health, cellulitis is a common condition that can impact healthcare utilization patterns, leading to increased emergency department visits and hospital admissions. Quality measures focus on timely diagnosis and treatment to reduce complications and improve patient outcomes.

ICD-9 vs ICD-10

The clinical significance of L03.21 lies in its potential to lead to serious complications if not treated promptly, including systemic infection or abscess formation. In terms of population health, cellulitis is a common condition that can impact healthcare utilization patterns, leading to increased emergency department visits and hospital admissions. Quality measures focus on timely diagnosis and treatment to reduce complications and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the infection and the complexity of the treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant details, including the patient's history, examination findings, and treatment response, are clearly documented to support the claim and avoid audit issues.

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 L03.21?

L03.21 specifically covers cellulitis and acute lymphangitis localized to the face, typically caused by bacterial infections such as Streptococcus or Staphylococcus species. It is characterized by inflammation, swelling, and potential systemic symptoms.

When should L03.21 be used instead of related codes?

L03.21 should be used when the cellulitis is specifically located on the face and is accompanied by acute lymphangitis. It is important to differentiate from other cellulitis codes that do not specify the location or associated conditions.

What documentation supports L03.21?

Documentation should include a detailed clinical assessment, noting the location and extent of the cellulitis, any systemic symptoms, treatment provided, and response to therapy. Laboratory results and imaging studies, if performed, should also be included.