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ICD-10 Guide
ICD-10 CodesL03.90

L03.90

Billable

Cellulitis, unspecified

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

Code Description

ICD-10 L03.90 is a billable code used to indicate a diagnosis of cellulitis, unspecified.

Key Diagnostic Point:

Cellulitis, unspecified (ICD-10 code L03.90) refers to a common bacterial skin infection characterized by inflammation of the skin and subcutaneous tissues. Clinically, it presents as a red, swollen area that feels warm and tender to the touch, often accompanied by systemic symptoms such as fever and chills. The infection typically occurs when bacteria enter through a break in the skin, which can be due to cuts, insect bites, or other skin injuries. The most commonly affected areas include the legs and face, although cellulitis can occur anywhere on the body. Disease progression can lead to severe complications if left untreated, including abscess formation and systemic infection. Diagnostic considerations include a thorough clinical examination and, in some cases, imaging studies to rule out deeper infections or abscesses. Laboratory tests may be performed to identify the causative organism, although empirical treatment is often initiated based on clinical suspicion. Accurate diagnosis and timely intervention are crucial to prevent complications and ensure effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical assessment and sometimes imaging.
  • Treatment complexity: May involve antibiotics and monitoring for complications.
  • Documentation requirements: Detailed clinical notes are essential for accurate coding.
  • Coding specificity: Limited specificity as it is classified as 'unspecified'.

Audit Risk Factors

  • Common coding errors: Misuse of related codes leading to incorrect billing.
  • Documentation gaps: Incomplete clinical notes may lead to denials.
  • Billing challenges: Difficulty in justifying the use of unspecified codes.

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

Cellulitis is a significant public health concern, affecting a diverse population and leading to increased healthcare utilization. The condition can result in hospitalizations, particularly among older adults and those with comorbidities. Quality measures often focus on timely diagnosis and treatment to reduce complications. Understanding the epidemiology of cellulitis can aid in developing preventive strategies, especially in high-risk populations, thereby improving overall healthcare outcomes.

ICD-9 vs ICD-10

Cellulitis is a significant public health concern, affecting a diverse population and leading to increased healthcare utilization. The condition can result in hospitalizations, particularly among older adults and those with comorbidities. Quality measures often focus on timely diagnosis and treatment to reduce complications. Understanding the epidemiology of cellulitis can aid in developing preventive strategies, especially in high-risk populations, thereby improving overall healthcare outcomes.

Reimbursement & Billing Impact

reimbursement and to maintain thorough records to support the medical necessity of the services rendered. Best practices include regular audits of coding accuracy and ensuring that all clinical encounters are well-documented.

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 L03.90?

L03.90 covers cases of cellulitis where the specific site of infection is not documented. This may include generalized cellulitis without further specification of the affected area.

When should L03.90 be used instead of related codes?

L03.90 should be used when the clinical documentation does not specify the site of cellulitis. If the site is known, related codes such as L03.91 or L03.92 should be selected for more accurate coding.

What documentation supports L03.90?

Documentation should include a clear description of the clinical presentation, any relevant history of skin injury, and the absence of specific site identification. Notes on treatment response and any systemic symptoms should also be included.