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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:

Cellulitis of the Popliteal FossaKnee Cellulitis

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

CodeDescriptionWhen to UseKey Documentation
L03.115Cellulitis of right lower limbUse when cellulitis is confirmed in the right popliteal area without specific complications.
  • Erythema, warmth, and tenderness localized to the popliteal fossa
  • WBC >12,000/μL, CRP >10 mg/dL
L03.116Cellulitis of left lower limbUse when cellulitis is confirmed in the left popliteal area without specific complications.
  • Erythema, warmth, and tenderness localized to the popliteal fossa
  • WBC >12,000/μL, CRP >10 mg/dL
L03.119Cellulitis of unspecified lower limbUse only when laterality is not documented.
  • Erythema, warmth, and tenderness in the lower limb
  • WBC >12,000/μL, CRP >10 mg/dL

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

The ICD-10 code for popliteal cellulitis is L03.115 for the right lower limb and L03.116 for the left lower limb.

Primary ICD-10-CM Codes for popliteal cellulitis

Cellulitis of right lower limb
Billable Code

Decision Criteria

clinical Criteria

  • Presence of erythema and swelling in the right popliteal area

Applicable To

  • Cellulitis of the right 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

Code-Specific Risks

  • Missing laterality documentation
  • Incorrect sequencing with wound or diabetes codes

Coding Notes

  • Ensure laterality is documented to avoid using unspecified codes.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Methicillin-resistant Staphylococcus aureus (MRSA)

B95.61
Use if MRSA is confirmed as the causative organism.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Popliteal cyst

M71.2
Presence of a fluid-filled cyst behind the knee, not an infection.

Documentation & 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 Medicine

Required Elements

  • Location and laterality of cellulitis
  • Presence of systemic symptoms
  • Response to initial treatment

Example Documentation

Patient presents with 5x7 cm erythematous, tender area in right popliteal fossa. Temp 101.2°F, WBC 14,200/μL. Plan: IV antibiotics, elevate limb.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has leg pain. Start antibiotics.
Good Documentation Example
5x7 cm erythematous, tender area in right popliteal fossa with peau d’orange texture. No fluctuance or crepitus. Temp 101.2°F, WBC 14,200/μL. Rule out DVT with Doppler. Plan: IV vancomycin, elevate limb.
Explanation
The good example provides specific location, size, and clinical findings, supporting the diagnosis and treatment plan.

Need help with ICD-10 coding for Popliteal Cellulitis? Ask your questions below.

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