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L04

Non-Billable (Header)

Acute lymphadenitis

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

L04 is the ICD-10-CM diagnosis code for acute lymphadenitis. L04 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering infections of the skin and subcutaneous tissue (l00-l08).

Header codes like L04 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at L04's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L04 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • abscess (acute) of lymph nodes, except mesenteric
  • acute lymphadenitis, except mesenteric

Excludes 1 — Do NOT code together

  • chronic or subacute lymphadenitis, except mesenteric (I88.1)
  • enlarged lymph nodes (R59.-)
  • human immunodeficiency virus [HIV] disease resulting in generalized lymphadenopathy (B20)
  • lymphadenitis NOS (I88.9)
  • nonspecific mesenteric lymphadenitis (I88.0)

Child Codes

Code Hierarchy

L04Acute lymphadenitis
L04Acute lymphadenitis

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