L03.213 ICD-10-CM Code: Periorbital cellulitis

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for L03.213 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on L03.213 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for L03.213

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

The conditions the Use Additional Code note names

Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

• Excludes2 — not part of L03.213(24 notes)

  Coding workflow: The conditions named in this note are not included in L03.213. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareK61, H60.1, H00.0, N76.4, H04.3, N48.2

  See the official tabular notes · Guidelines I.A.12.b

• Use Additional Code — after identifying L03.213(1 note)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with L03.213 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Cellulitis (diffuse) (phlegmonous) (septic) (suppurative), periorbital
• Cellulitis (diffuse) (phlegmonous) (septic) (suppurative), preseptal

Don’t confuse L03.213 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of L03.213 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• K61— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of cellulitis of anal and rectal region adds K61; it is not part of this code and both may be reported when both are documented.

  Full comparison: L03.213 vs K61 →

• H60.1— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of cellulitis of external auditory canal adds H60.1; it is not part of this code and both may be reported when both are documented.

  Full comparison: L03.213 vs H60.1 →

• H00.0— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of cellulitis of eyelid adds H00.0; it is not part of this code and both may be reported when both are documented.

  Full comparison: L03.213 vs H00.0 →

• N76.4— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of cellulitis of female external genital organs adds N76.4; it is not part of this code and both may be reported when both are documented.

  Full comparison: L03.213 vs N76.4 →

• H04.3— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of cellulitis of lacrimal apparatus adds H04.3; it is not part of this code and both may be reported when both are documented.

  Full comparison: L03.213 vs H04.3 →

• N48.2— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of cellulitis of male external genital organs adds N48.2; it is not part of this code and both may be reported when both are documented.

  Full comparison: L03.213 vs N48.2 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name L03.213 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: I89.1 — Lymphangitis (via L03.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 5 Excludes2 notes: L03.12 — Acute lymphangitis of other parts of limb (via L03.2.-), L89 — Pressure ulcer (via L03.-), L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified (via L03.-), L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified (via L03.-), L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified (via L03.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Use Additional Code instruction: T65.84 — Toxic effect of xylazine (via L03.-).

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 45 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 10 MS-DRGs: DRG 011 (MDC PRE), DRG 012 (MDC PRE), DRG 013 (MDC PRE), DRG 573 (MDC 09), DRG 574 (MDC 09), DRG 575 (MDC 09), DRG 602 (MDC 09), DRG 603 (MDC 09), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SKN001 — Skin and subcutaneous tissue infections (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

A49.2 — Hemophilus influenzae infection, unspecified site, A49.3 — Mycoplasma infection, unspecified site, A49.8 — Other bacterial infections of unspecified site, A49.9 — Bacterial infection, unspecified, B78.1 — Cutaneous strongyloidiasis, E83.2 — Disorders of zinc metabolism, L02.811 — Cutaneous abscess of head [any part, except face], L02.818 — Cutaneous abscess of other sites, L02.91 — Cutaneous abscess, unspecified, L03.211 — Cellulitis of face, L03.811 — Cellulitis of head [any part, except face], L03.818 — Cellulitis of other sites, L03.891 — Acute lymphangitis of head [any part, except face], L03.898 — Acute lymphangitis of other sites, L03.90 — Cellulitis, unspecified, L03.91 — Acute lymphangitis, unspecified, L08.0 — Pyoderma, L08.81 — Pyoderma vegetans, L08.82 — Omphalitis not of newborn, L08.89 — Other specified local infections of the skin and subcutaneous tissue, +24 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Skin and subcutaneous tissue infections).

L03.119 — Cellulitis of unspecified part of limb, L03.121 — Acute lymphangitis of right axilla, L03.122 — Acute lymphangitis of left axilla, L03.123 — Acute lymphangitis of right upper limb, L03.124 — Acute lymphangitis of left upper limb, L03.125 — Acute lymphangitis of right lower limb, L03.126 — Acute lymphangitis of left lower limb, L03.129 — Acute lymphangitis of unspecified part of limb, L03.211 — Cellulitis of face, L03.212 — Acute lymphangitis of face, L03.221 — Cellulitis of neck, L03.222 — Acute lymphangitis of neck, L03.311 — Cellulitis of abdominal wall, L03.312 — Cellulitis of back [any part except buttock and flank], L03.313 — Cellulitis of chest wall, L03.314 — Cellulitis of groin, L03.315 — Cellulitis of perineum, L03.316 — Cellulitis of umbilicus, L03.317 — Cellulitis of buttock, L03.319 — Cellulitis of trunk, unspecified, +150 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Cellulitis”; these codes share that main term but sit in a different category of the Tabular List.

J38.3 — Other diseases of vocal cords (vocal cord), J38.7 — Other diseases of larynx (larynx), J39.1 — Other abscess of pharynx (pharynx), K11.3 — Abscess of salivary gland (submaxillary, gland), K12.2 — Cellulitis and abscess of mouth (mouth), K13.0 — Diseases of lips (lip), K61.0 — Anal abscess (anus), K61.1 — Rectal abscess (rectum), K65.0 — Generalized (acute) peritonitis (pelvis, pelvic, male), K68.9 — Other disorders of retroperitoneum (retroperitoneal), L98.3 — Eosinophilic cellulitis [Wells] (eosinophilic), N34.0 — Urethral abscess (periurethral), N48.22 — Cellulitis of corpus cavernosum and penis (penis), N49.0 — Inflammatory disorders of seminal vesicle (seminal vesicle), N49.2 — Inflammatory disorders of scrotum (scrotum), N49.8 — Inflammatory disorders of other specified male genital organs (genital organ NEC, male, specified NEC), N49.9 — Inflammatory disorder of unspecified male genital organ (genital organ NEC, male), N61.0 — Mastitis without abscess (nipple), N73.0 — Acute parametritis and pelvic cellulitis (periuterine, acute), N73.2 — Unspecified parametritis and pelvic cellulitis (periuterine), +13 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HIV Screening Test

Contextual Map

Every relationship of L03.213 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run L03.213 with these 7 related codes in Claim Check

Hierarchy

• L00-L99 — Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99) (L00-L99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L00-L08 — Infections of the skin and subcutaneous tissue[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• I89.1 — Lymphangitis[Excludes1](via L03.-): “acute lymphangitis (L03.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

• L03.12 — Acute lymphangitis of other parts of limb[Excludes2](via L03.2.-): “acute lymphangitis of fingers (L03.2-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• L89 — Pressure ulcer[Excludes2](via L03.-): “skin infections (L00-L08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified[Excludes2](via L03.-): “skin infections (L00-L08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified[Excludes2](via L03.-): “skin infections (L00-L08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified[Excludes2](via L03.-): “skin infections (L00-L08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Use Additional Code instructions

• T65.84 — Toxic effect of xylazine[Use Additional Code](via L03.-): “cellulitis and acute lymphangitis (L03.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• SKN001 — Skin and subcutaneous tissue infections[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper (10)

• CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 011 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC[MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 012 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC[MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 013 — TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC[MS-DRG]: “TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC (MDC PRE)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 573 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC[MS-DRG]: “SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC (MDC 09)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 574 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC[MS-DRG]: “SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC (MDC 09)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 575 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC[MS-DRG]: “SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC (MDC 09)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 602 — CELLULITIS WITH MCC[MS-DRG]: “CELLULITIS WITH MCC (MDC 09)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• and 3 more

MDC crossing

• Pre-MDC[MDC crossing]: “Pre-MDC — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 153 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
• MDC 09 — Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast[MDC crossing]: “Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 7,376 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Cellulitis (diffuse) (phlegmonous) (septic) (suppurative), periorbital[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Cellulitis (diffuse) (phlegmonous) (septic) (suppurative), preseptal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

• L03 — Cellulitis and acute lymphangitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.11 — Cellulitis of other parts of limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.111 — Cellulitis of right axilla[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.112 — Cellulitis of left axilla[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.113 — Cellulitis of right upper limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.114 — Cellulitis of left upper limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.115 — Cellulitis of right lower limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• L03.116 — Cellulitis of left lower limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 more

Change history

• FY2017 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2017

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to L03.213 in its code family, with their registry titles.

• L03.129 — Acute lymphangitis of unspecified part of limb
• L03.2 — Cellulitis and acute lymphangitis of face and neck
• L03.21 — Cellulitis and acute lymphangitis of face
• L03.211 — Cellulitis of face
• L03.212 — Acute lymphangitis of face
• L03.22 — Cellulitis and acute lymphangitis of neck
• L03.221 — Cellulitis of neck
• L03.222 — Acute lymphangitis of neck
• L03.3 — Cellulitis and acute lymphangitis of trunk
• L03.31 — Cellulitis of trunk

View all codes in the L03 family