L04 ICD-10-CM Code: Acute lymphadenitis
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 2 inclusion terms · 5 Excludes1 · 13 Excludes2 · 1 use-additional code
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for L04 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 L04 itself; “inherited from” names the category or block whose note applies here.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- abscess (acute) of lymph nodes, except mesenteric
- acute lymphadenitis, except mesenteric
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- chronic or subacute lymphadenitis, except mesenteric (I88.1) Compare L04 vs I88.1 →
- enlarged lymph nodes (R59.-) Compare L04 vs R59 →
- human immunodeficiency virus [HIV] disease resulting in generalized lymphadenopathy (B20) Compare L04 vs B20 →
- lymphadenitis NOS (I88.9) Compare L04 vs I88.9 →
- nonspecific mesenteric lymphadenitis (I88.0) Compare L04 vs I88.0 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- hordeolum (H00.0) inherited from L00-L08Compare L04 vs H00.0 →
- infective dermatitis (L30.3) inherited from L00-L08Compare L04 vs L30.3 →
- local infections of skin classified in Chapter 1 inherited from L00-L08
- lupus panniculitis (L93.2) inherited from L00-L08Compare L04 vs L93.2 →
- panniculitis NOS (M79.3) inherited from L00-L08Compare L04 vs M79.3 →
- panniculitis of neck and back (M54.0-) inherited from L00-L08Compare L04 vs M54.0 →
- Perlèche NOS (K13.0) inherited from L00-L08Compare L04 vs K13.0 →
- Perlèche due to candidiasis (B37.0) inherited from L00-L08Compare L04 vs B37.0 →
- Perlèche due to riboflavin deficiency (E53.0) inherited from L00-L08Compare L04 vs E53.0 →
- pyogenic granuloma (L98.0) inherited from L00-L08Compare L04 vs L98.0 →
- relapsing panniculitis Weber-Christian
- viral warts (B07.-) inherited from L00-L08Compare L04 vs B07 →
- zoster (B02.-) inherited from L00-L08Compare L04 vs B02 →
Coder workflow for L04
MedCoder structured workflow — derived from this code’s own official record
Before you code L04
- L04 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewL04.0, L04.1, L04.2, L04.3, L04.8, L04.9
See the relationships section · Guide: How to choose an ICD-10-CM code →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with L04. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support one of the more specific codes beneath L04?
Yes → Select that code and continue the checks below on its own page.
No → L04 cannot be reported as written; query for the specificity its subcategory needs. - Does the documentation support a condition named in L04’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider L04. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.
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).
- Acuity
- Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
- 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
Excludes1 — check before selecting L04(5 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with L04: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareI88.1, R59, B20, I88.9, I88.0
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of L04(13 notes)
Coding workflow: The conditions named in this note are not included in L04. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareH00.0, L30.3, L93.2, M79.3, M54.0, K13.0
See the official tabular notes · Guidelines I.A.12.b
Use Additional Code — after identifying L04(1 note)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with L04 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
Documentation: Both the condition L04 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with L04?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
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.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Decision Points
The directives on this code's own record, as a pre-claim checklist.
- 1 Use Additional Code instruction — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
- 5 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
- 13 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes
Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.
Verify Before Coding
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 L04 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 2 Excludes1 notes across 2 chapters: I88 — Nonspecific lymphadenitis, R59 — Enlarged lymph nodes.
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 across 2 chapters: D75 — Other and unspecified diseases of blood and blood-forming organs, L89 — Pressure ulcer, L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified, L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified, L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified.
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Contextual Map
Every relationship of L04 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 L04 with these 22 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
Excludes1
- B20 — Human immunodeficiency virus [HIV] disease[Excludes1]: “human immunodeficiency virus [HIV] disease resulting in generalized lymphadenopathy (B20)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I88.0 — Nonspecific mesenteric lymphadenitis[Excludes1]: “nonspecific mesenteric lymphadenitis (I88.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I88.1 — Chronic lymphadenitis, except mesenteric[Excludes1]: “chronic or subacute lymphadenitis, except mesenteric (I88.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- I88.9 — Nonspecific lymphadenitis, unspecified[Excludes1]: “lymphadenitis NOS (I88.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R59 — Enlarged lymph nodes[Excludes1]: “enlarged lymph nodes (R59.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Excludes2 (12)
- B02 — Zoster [herpes zoster][Excludes2]: “zoster (B02.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- B07 — Viral warts[Excludes2]: “viral warts (B07.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- B37.0 — Candidal stomatitis[Excludes2]: “Perlèche due to candidiasis (B37.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- E53.0 — Riboflavin deficiency[Excludes2]: “Perlèche due to riboflavin deficiency (E53.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- H00.0 — Hordeolum (externum) (internum) of eyelid[Excludes2]: “hordeolum (H00.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- K13.0 — Diseases of lips[Excludes2]: “Perlèche NOS (K13.0)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- L30.3 — Infective dermatitis[Excludes2]: “infective dermatitis (L30.3)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- L93.2 — Other local lupus erythematosus[Excludes2]: “lupus panniculitis (L93.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- and 4 more
Use Additional Code
- B95 — Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere[Use Additional Code]: “code (B95-B97) to identify infectious agent.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- B96 — Other bacterial agents as the cause of diseases classified elsewhere[Use Additional Code]: “code (B95-B97) to identify infectious agent.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- B97 — Viral agents as the cause of diseases classified elsewhere[Use Additional Code]: “code (B95-B97) to identify infectious agent.”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes1 notes
- I88 — Nonspecific lymphadenitis[Excludes1]: “acute lymphadenitis, except mesenteric (L04.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- R59 — Enlarged lymph nodes[Excludes1]: “acute lymphadenitis (L04.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes
- D75 — Other and unspecified diseases of blood and blood-forming organs[Excludes2]: “acute lymphadenitis (L04.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- L89 — Pressure ulcer[Excludes2]: “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]: “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]: “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]: “skin infections (L00-L08)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes
- L04.0 — Acute lymphadenitis of face, head and neck[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- L04.1 — Acute lymphadenitis of trunk[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- L04.2 — Acute lymphadenitis of upper limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- L04.3 — Acute lymphadenitis of lower limb[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- L04.8 — Acute lymphadenitis of other sites[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- L04.9 — Acute lymphadenitis, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can L04 be billed directly?
No. L04 (Acute lymphadenitis) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
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
- 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
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "L04 — Acute lymphadenitis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/l04-acute-lymphadenitis
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionAcute lymphadenitis
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to L04 in its code family, with their registry titles.