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ICD-10 Guide
ICD-10 CodesL03.111

L03.111

Billable

Cellulitis of right axilla

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

Code Description

ICD-10 L03.111 is a billable code used to indicate a diagnosis of cellulitis of right axilla.

Key Diagnostic Point:

Cellulitis of the right axilla is an acute bacterial infection of the skin and subcutaneous tissues, characterized by inflammation, redness, warmth, and swelling in the affected area. The axilla, or armpit, is a region prone to infections due to its warm, moist environment and proximity to hair follicles and lymphatic structures. Clinically, patients may present with localized pain, tenderness, and systemic symptoms such as fever and malaise. The disease often progresses rapidly, and if left untreated, it can lead to complications such as abscess formation or systemic spread of infection. Diagnosis is primarily clinical, supported by patient history and physical examination, although imaging studies may be utilized to rule out abscesses or deeper infections. Laboratory tests, including blood cultures, may be indicated in severe cases or when systemic involvement is suspected. Prompt recognition and treatment are crucial to prevent complications and ensure favorable outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and may involve differential diagnosis.
  • Treatment complexity: Typically involves antibiotics and may require surgical intervention for abscesses.
  • Documentation requirements: Detailed clinical notes are necessary to justify the diagnosis and treatment.
  • Coding specificity: Requires accurate coding to specify the location and nature of the cellulitis.

Audit Risk Factors

  • Common coding errors: Misidentification of the site or severity of cellulitis.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials due to lack of clear evidence of infection or treatment rationale.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cellulitis of the right axilla can significantly impact patient health, leading to increased healthcare utilization due to potential complications such as abscess formation or systemic infection. It is essential for healthcare providers to recognize and treat this condition promptly to improve patient outcomes and reduce the burden on healthcare systems. Epidemiologically, cellulitis is a common condition, particularly in populations with comorbidities such as diabetes or immunosuppression, highlighting the need for effective management strategies.

ICD-9 vs ICD-10

Cellulitis of the right axilla can significantly impact patient health, leading to increased healthcare utilization due to potential complications such as abscess formation or systemic infection. It is essential for healthcare providers to recognize and treat this condition promptly to improve patient outcomes and reduce the burden on healthcare systems. Epidemiologically, cellulitis is a common condition, particularly in populations with comorbidities such as diabetes or immunosuppression, highlighting the need for effective management strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the infection and the complexity of care. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services rendered. Best practices include ensuring that all clinical notes are complete and that the rationale for antibiotic therapy or any surgical intervention is clearly outlined in the patient’s medical record.

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 L03.111?

L03.111 covers cellulitis specifically localized to the right axilla, which may arise from various causes including trauma, insect bites, or surgical wounds. It is important to differentiate it from other skin infections such as abscesses or necrotizing fasciitis.

When should L03.111 be used instead of related codes?

L03.111 should be used when the cellulitis is confirmed to be localized to the right axilla. If the infection involves other areas or is bilateral, other codes such as L03.112 or L03.113 should be considered.

What documentation supports L03.111?

Documentation should include a thorough history and physical examination, noting the onset of symptoms, any contributing factors, and the clinical findings that support the diagnosis of cellulitis in the right axilla.