ICD-10 Coding for Popliteal Cellulitis(L03.115, L03.116, L03.119)
Complete ICD-10-CM coding and documentation guide for Popliteal Cellulitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Popliteal Cellulitis
L03.11-Primary Range
Cellulitis of the lower limb
This range includes cellulitis of the popliteal area, which is part of the lower limb.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L03.115 | Cellulitis of right lower limb | Use when cellulitis is confirmed in the right popliteal area without specific complications. |
|
| L03.116 | Cellulitis of left lower limb | Use when cellulitis is confirmed in the left popliteal area without specific complications. |
|
| L03.119 | Cellulitis of unspecified lower limb | Use only when laterality is not documented. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for popliteal cellulitis
Essential facts and insights about Popliteal Cellulitis
Primary ICD-10-CM Codes for popliteal cellulitis
Decision Criteria
clinical Criteria
- Presence of erythema and swelling in the right popliteal area
Applicable To
- Cellulitis of the right popliteal area
Clinical Validation Requirements
- Erythema, warmth, and tenderness localized to the popliteal fossa
- WBC >12,000/μL, CRP >10 mg/dL
Code-Specific Risks
- Missing laterality documentation
- Incorrect sequencing with wound or diabetes codes
Coding Notes
- Ensure laterality is documented to avoid using unspecified codes.
L03.116 - Cellulitis of left lower limb
Use when cellulitis is confirmed in the left popliteal area without specific complications.
Applicable To
- Cellulitis of the left popliteal area
Excludes
- Phlebitis of lower extremity veins (I80.2)
- Popliteal cyst (M71.2)
Clinical Validation Requirements
- Erythema, warmth, and tenderness localized to the popliteal fossa
- WBC >12,000/μL, CRP >10 mg/dL
Coding Notes
Ensure laterality is documented to avoid using unspecified codes.
L03.119 - Cellulitis of unspecified lower limb
Use only when laterality is not documented.
Applicable To
- Cellulitis of the lower limb when laterality is not documented
Excludes
- Phlebitis of lower extremity veins (I80.2)
- Popliteal cyst (M71.2)
Clinical Validation Requirements
- Erythema, warmth, and tenderness in the lower limb
- WBC >12,000/μL, CRP >10 mg/dL
Coding Notes
Avoid using this code if laterality can be determined.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Methicillin-resistant Staphylococcus aureus (MRSA)
B95.61Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Popliteal cyst
M71.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Popliteal Cellulitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L03.115.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Review documentation for laterality before coding.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases the quality and accuracy of health data.
Mitigation Strategy
Ensure laterality is documented in the medical record.
Impact
Reimbursement: Incorrect sequencing can affect DRG assignment., Compliance: Non-compliance with coding guidelines for diabetes complications., Data Quality: Inaccurate representation of the patient's condition.
Mitigation Strategy
Document explicit linkage between cellulitis and diabetes before using E11.62.
Impact
Failure to document laterality can lead to audit findings.
Mitigation Strategy
Implement checklist to ensure laterality is documented.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Popliteal Cellulitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Popliteal Cellulitis
Use these documentation templates to ensure complete and accurate documentation for Popliteal Cellulitis. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Popliteal Cellulitis
Specialty: Emergency MedicineRequired Elements
- Location and laterality of cellulitis
- Presence of systemic symptoms
- Response to initial treatment
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Popliteal Cellulitis? Ask your questions below.