ICD-10 L04
Non-Billable HeaderAcute lymphadenitis
About ICD-10-CM L04
ICD-10-CM code L04 represents Acute lymphadenitis. This is a non-billable header code in the Skin and Subcutaneous Tissue chapter (block L04). The 2026 edition of ICD-10-CM L04 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with L04. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- 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)
Includes
- abscess (acute) of lymph nodes, except mesenteric
- acute lymphadenitis, except mesenteric
Medicare LCD Coverage for L04
Local Coverage Determinations (LCDs) from CMS MACs that list L04 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing L04.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but L04 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with L04
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To L04
Other codes in section L00-L08 (Infections of the skin and subcutaneous tissue).
ICD-10 L04, Billing FAQ
Is ICD-10 code L04 billable? +
No, L04 is a non-billable header code. Use a more specific child code from block L04 when submitting claims.
What codes are Type 1 Excludes for L04? +
Type 1 Excludes (never code together with L04): chronic or subacute lymphadenitis, except mesenteric (I88.1); enlarged lymph nodes (R59.-); human immunodeficiency virus [HIV] disease resulting in generalized lymphadenopathy (B20)
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team