ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesL04.2

L04.2

Billable

Acute lymphadenitis of upper limb

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

Code Description

ICD-10 L04.2 is a billable code used to indicate a diagnosis of acute lymphadenitis of upper limb.

Key Diagnostic Point:

Acute lymphadenitis of the upper limb is an inflammatory condition characterized by the swelling and tenderness of lymph nodes in the axillary or brachial regions, often due to infection. The condition typically arises from bacterial infections, such as staphylococcal or streptococcal infections, which can originate from skin wounds, insect bites, or systemic infections. Clinically, patients may present with localized pain, erythema, and warmth over the affected area, along with systemic symptoms like fever and malaise. The anatomy involved includes the lymphatic system, particularly the lymph nodes and associated vessels in the upper limb. Disease progression can lead to abscess formation if not treated promptly, necessitating surgical intervention in severe cases. Diagnostic considerations include physical examination, imaging studies (like ultrasound), and laboratory tests to identify the causative organism. Accurate diagnosis is crucial for effective treatment, which may involve antibiotics and, in some cases, drainage of abscesses.

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 surgical intervention.
  • Documentation requirements: Detailed clinical notes and lab results are necessary.
  • Coding specificity: Requires precise coding to differentiate from other lymphadenitis codes.

Audit Risk Factors

  • Common coding errors: Misclassification with other lymphadenitis codes.
  • Documentation gaps: Incomplete clinical notes regarding the cause and treatment.
  • Billing challenges: Denials may occur if 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 upper limb can significantly affect patient quality of life due to pain and systemic symptoms. It is essential for healthcare providers to recognize and treat this condition promptly to prevent complications such as abscess formation. Understanding the epidemiology of this condition can help in developing preventive strategies, particularly in populations at higher risk for skin infections. Effective management can reduce healthcare utilization and improve overall population health outcomes.

ICD-9 vs ICD-10

Acute lymphadenitis of the upper limb can significantly affect patient quality of life due to pain and systemic symptoms. It is essential for healthcare providers to recognize and treat this condition promptly to prevent complications such as abscess formation. Understanding the epidemiology of this condition can help in developing preventive strategies, particularly in populations at higher risk for skin infections. Effective management can reduce healthcare utilization and improve overall population health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of infection and the rationale for any surgical procedures performed. Common denials may arise from insufficient documentation or lack of supporting lab results. Best practices include maintaining comprehensive clinical notes, ensuring that all relevant procedures are coded accurately, and following up on any claims that are denied to address potential issues promptly.

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 L04.2?

L04.2 specifically covers acute lymphadenitis of the upper limb, which may be due to localized infections, systemic infections, or complications from skin conditions. It does not include chronic lymphadenitis or lymphadenopathy due to malignancies.

When should L04.2 be used instead of related codes?

L04.2 should be used when there is a clear diagnosis of acute lymphadenitis localized to the upper limb, particularly when accompanied by signs of infection. Related codes may be more appropriate for generalized lymphadenopathy or lymphadenitis in other regions.

What documentation supports L04.2?

Documentation should include a thorough clinical evaluation, details of the patient's symptoms, laboratory results confirming infection, and any imaging studies performed. Notes should also reflect the treatment plan and response to therapy.