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ICD-10 Guide
ICD-10 CodesL04.0

L04.0

Billable

Acute lymphadenitis of face, head and neck

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

Code Description

ICD-10 L04.0 is a billable code used to indicate a diagnosis of acute lymphadenitis of face, head and neck.

Key Diagnostic Point:

Acute lymphadenitis of the face, head, and neck is characterized by the inflammation of lymph nodes in these regions, often due to bacterial infections, such as Staphylococcus or Streptococcus species. Clinically, patients may present with swollen, tender lymph nodes, fever, and localized pain. The anatomy involved includes the cervical lymph nodes, which drain the head and neck, and may also involve surrounding tissues such as the skin and subcutaneous layers. Disease progression can lead to abscess formation if not treated promptly, necessitating surgical intervention. Diagnostic considerations include a thorough clinical examination, imaging studies like ultrasound or CT scans to assess lymph node enlargement, and laboratory tests to identify the causative organism. Differential diagnoses may include other causes of lymphadenopathy, such as viral infections or malignancies, making accurate diagnosis crucial for effective treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other causes of lymphadenopathy.
  • Treatment complexity: May involve antibiotics and, in severe cases, surgical drainage.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires precise coding to reflect the site and nature of the condition.

Audit Risk Factors

  • Common coding errors: Misidentification of the site or type of lymphadenitis.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials if the documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Primary medical 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

Secondary 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

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

Acute lymphadenitis of the face, head, and neck can significantly impact patient health, leading to complications if untreated. It is essential for population health as it may indicate underlying infections that could spread. Quality measures include timely diagnosis and treatment, which can reduce healthcare utilization patterns, such as emergency visits or hospital admissions. Epidemiologically, this condition is more prevalent in children and can be associated with other infectious diseases, highlighting the need for awareness and prompt intervention.

ICD-9 vs ICD-10

Acute lymphadenitis of the face, head, and neck can significantly impact patient health, leading to complications if untreated. It is essential for population health as it may indicate underlying infections that could spread. Quality measures include timely diagnosis and treatment, which can reduce healthcare utilization patterns, such as emergency visits or hospital admissions. Epidemiologically, this condition is more prevalent in children and can be associated with other infectious diseases, highlighting the need for awareness and prompt intervention.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the necessity for any surgical procedures. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services rendered. Coders should ensure that all relevant clinical information is included in the patient's record to support the diagnosis and any associated procedures.

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 L04.0?

L04.0 specifically covers acute lymphadenitis in the face, head, and neck, typically resulting from bacterial infections. It does not include chronic lymphadenitis or lymphadenopathy due to malignancies.

When should L04.0 be used instead of related codes?

L04.0 should be used when the lymphadenitis is acute and localized to the face, head, or neck, distinguishing it from other codes that may pertain to chronic conditions or different anatomical sites.

What documentation supports L04.0?

Documentation should include clinical findings such as the size and tenderness of lymph nodes, fever, and any imaging studies performed. Laboratory results confirming bacterial infection would also support the diagnosis.