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ICD-10 Guide
ICD-10 CodesL04.3

L04.3

Billable

Acute lymphadenitis of lower limb

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

Code Description

ICD-10 L04.3 is a billable code used to indicate a diagnosis of acute lymphadenitis of lower limb.

Key Diagnostic Point:

Acute lymphadenitis of the lower limb is characterized by the inflammation of lymph nodes in the groin or popliteal region, often resulting from an infectious process. Clinically, patients may present with localized swelling, tenderness, erythema, and warmth over the affected area, accompanied by systemic symptoms such as fever and malaise. The anatomy involved primarily includes the lymphatic system, particularly the lymph nodes that drain the lower limb. Disease progression can vary; if untreated, acute lymphadenitis may lead to abscess formation or systemic infection. Diagnostic considerations include a thorough clinical examination, imaging studies such as ultrasound to assess lymph node enlargement, and laboratory tests to identify the causative organism, which may include bacterial cultures. Prompt diagnosis and treatment are essential to prevent complications and ensure optimal patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and may involve imaging and laboratory tests.
  • Treatment complexity: Treatment may involve antibiotics, and in some cases, surgical intervention if abscesses develop.
  • Documentation requirements: Detailed documentation of clinical findings, treatment plans, and follow-up is necessary.
  • Coding specificity: Requires accurate coding to differentiate from other types of lymphadenitis.

Audit Risk Factors

  • Common coding errors: Misidentification of the site of lymphadenitis or failure to specify acute vs. chronic.
  • Documentation gaps: Incomplete clinical notes regarding the extent of lymphadenitis or treatment provided.
  • Billing challenges: Potential denials if documentation does not support the diagnosis or if coding is not specific enough.

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 lower limb can significantly impact patient health, leading to complications if not treated promptly. It is important for population health as it may indicate underlying infections that could spread. Quality measures related to timely diagnosis and treatment can improve healthcare outcomes. Understanding the epidemiology of this condition helps in recognizing patterns of infection and guiding preventive measures.

ICD-9 vs ICD-10

Acute lymphadenitis of the lower limb can significantly impact patient health, leading to complications if not treated promptly. It is important for population health as it may indicate underlying infections that could spread. Quality measures related to timely diagnosis and treatment can improve healthcare outcomes. Understanding the epidemiology of this condition helps in recognizing patterns of infection and guiding preventive measures.

Reimbursement & Billing Impact

Acute lymphadenitis of the lower limb can significantly impact patient health, leading to complications if not treated promptly. It is important for population health as it may indicate underlying infections that could spread. Quality measures related to timely diagnosis and treatment can improve healthcare outcomes. Understanding the epidemiology of this condition helps in recognizing patterns of infection and guiding preventive measures.

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 L04.3?

L04.3 specifically covers acute lymphadenitis of the lower limb, which may arise from infections such as cellulitis, abscesses, or systemic infections that spread to lymph nodes. It is important to differentiate it from chronic lymphadenitis and other related conditions.

When should L04.3 be used instead of related codes?

L04.3 should be used when the lymphadenitis is acute and specifically localized to the lower limb. If the lymphadenitis is due to a different cause or located in another region, appropriate codes such as L04.0 or L04.1 should be selected.

What documentation supports L04.3?

Documentation should include clinical findings such as the presence of swelling, tenderness, and systemic symptoms, as well as results from imaging studies and laboratory tests that confirm the diagnosis of acute lymphadenitis.