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ICD-10 Guide
ICD-10 CodesL03.317

L03.317

Billable

Cellulitis of buttock

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

Code Description

ICD-10 L03.317 is a billable code used to indicate a diagnosis of cellulitis of buttock.

Key Diagnostic Point:

Cellulitis of the buttock is a bacterial skin infection that affects the dermis and subcutaneous tissues. Clinically, it presents as a painful, swollen area that may be warm to the touch and is often accompanied by redness and tenderness. The buttock region, being a common site for cellulitis, can be affected due to various factors including skin breaks, insect bites, or surgical wounds. Disease progression can lead to systemic symptoms such as fever and chills if left untreated. Diagnosis is primarily clinical, supported by patient history and physical examination, although imaging may be utilized to rule out abscess formation or deeper tissue involvement. Laboratory tests, including blood cultures, may be indicated in severe cases or when systemic infection is suspected. Prompt recognition and treatment are crucial to prevent complications such as necrotizing fasciitis or sepsis.

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: Must include detailed clinical findings and treatment plans.
  • Coding specificity: Requires accurate identification of the site and severity of cellulitis.

Audit Risk Factors

  • Common coding errors: Misidentification of the site or severity.
  • Documentation gaps: Incomplete records regarding the clinical presentation or treatment.
  • Billing challenges: Potential denials due to lack of supporting documentation or specificity.

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

Cellulitis of the buttock has significant clinical implications, particularly in populations with comorbidities such as diabetes or immunosuppression. It can lead to increased healthcare utilization due to hospital admissions and prolonged treatment courses. Understanding the epidemiology of cellulitis can help in developing preventive strategies and improving quality measures in patient care.

ICD-9 vs ICD-10

Cellulitis of the buttock has significant clinical implications, particularly in populations with comorbidities such as diabetes or immunosuppression. It can lead to increased healthcare utilization due to hospital admissions and prolonged treatment courses. Understanding the epidemiology of cellulitis can help in developing preventive strategies and improving quality measures in patient care.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the infection and any associated procedures performed, such as incision and drainage. Common denials may arise from insufficient documentation or lack of specificity in coding. Best practices include ensuring that all clinical notes are complete and that the rationale for treatment is clearly articulated in the 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 L03.317?

L03.317 specifically covers cellulitis localized to the buttock region, which may arise from various etiologies including trauma, surgical wounds, or skin infections. It is important to differentiate it from other skin conditions such as abscesses or necrotizing fasciitis.

When should L03.317 be used instead of related codes?

L03.317 should be used when the cellulitis is specifically localized to the buttock area. If the infection is elsewhere, such as the lower limb or face, the appropriate related code should be selected based on the anatomical location.

What documentation supports L03.317?

Documentation should include a thorough clinical assessment, noting the onset, duration, and characteristics of the symptoms. Evidence of treatment plans, including prescribed antibiotics and any surgical interventions, should also be documented to support the diagnosis.