L40-L45
Medium Complexity

Papulosquamous disorders

Primary Specialty: Dermatology
Last Updated: 2025-09-09

ICD-10 Codes (25)

22 billable
0 category headers
L41
Parapsoriasis
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L41.0
Billable
Pityriasis lichenoides et varioliformis acuta
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L41.1
Billable
Pityriasis lichenoides chronica
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L41.3
Billable
Small plaque parapsoriasis
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L41.4
Billable
Large plaque parapsoriasis
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L41.5
Billable
Retiform parapsoriasis
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L41.8
Billable
Other parapsoriasis
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L41.9
Billable
Parapsoriasis, unspecified
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L42
Billable
Pityriasis rosea
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L43
Lichen planus
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L43.0
Billable
Hypertrophic lichen planus
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L43.1
Billable
Bullous lichen planus
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L43.2
Billable
Lichenoid drug reaction
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L43.3
Billable
Subacute (active) lichen planus
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L43.8
Billable
Other lichen planus
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L43.9
Billable
Lichen planus, unspecified
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L44
Other papulosquamous disorders
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L44.0
Billable
Pityriasis rubra pilaris
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L44.1
Billable
Lichen nitidus
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L44.2
Billable
Lichen striatus
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L44.3
Billable
Lichen ruber moniliformis
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L44.4
Billable
Infantile papular acrodermatitis [Gianotti-Crosti]
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L44.8
Billable
Other specified papulosquamous disorders
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L44.9
Billable
Papulosquamous disorder, unspecified
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L45
Billable
Papulosquamous disorders in diseases classified elsewhere
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Updates & Changes

FY 2026 Updates

Current Year

Deleted Codes

No codes deleted in this range for FY 2026

No significant changes for FY 2026

This range maintains stability with current coding practices

Historical Changes

  • FY 2025: Routine maintenance updates with minor terminology clarifications
  • FY 2024: Enhanced specificity requirements for certain code ranges
  • FY 2023: Updated documentation guidelines for improved clarity

Upcoming Changes

  • Proposed updates pending review by Coordination and Maintenance Committee
  • Under consideration: Enhanced digital health integration codes

Implementation Guidance

  • Review all FY 2026 updates for L40-L45 codes before implementation
  • Always verify the most current codes in the ICD-10-CM manual
  • Ensure clinical documentation supports the selected diagnosis codes
  • +3 more guidance items...

Range Overview

high priority

The ICD-10 code range L40-L45 is dedicated to papulosquamous disorders, a group of skin conditions characterized by papules and scales. These conditions include psoriasis, lichen planus, and pityriasis rosea, among others. The codes in this range are used to document the specific type of papulosquamous disorder, its location, and any associated complications.

Key Usage Points:

  • Always code to the highest level of specificity, including the type of disorder and location.
  • Use additional codes to document any associated conditions or complications.
  • Use combination codes when available to capture the full clinical picture.
  • Remember to update codes as the patient's condition changes or progresses.
  • Always verify the code in the ICD-10 manual before finalizing the claim.

Coding Guidelines

When to Use:

  • When a patient is diagnosed with a papulosquamous disorder.
  • When a patient is receiving treatment for a papulosquamous disorder.
  • When a patient has a history of a papulosquamous disorder that affects their current health status.
  • When a patient presents with symptoms indicative of a papulosquamous disorder.

When NOT to Use:

  • When the patient has a skin condition that is not a papulosquamous disorder.
  • When the patient's papulosquamous disorder is not relevant to the current visit.
  • When the patient's condition is better documented with a different code.
  • When the patient's condition is still under investigation.

Code Exclusions

Always verify exclusions with the provider and the ICD-10 manual.

Documentation Requirements

Documentation for papulosquamous disorders should clearly indicate the specific diagnosis, location of the disorder, and any associated complications. The provider's notes should support the chosen code.

Clinical Information:

  • Specific diagnosis
  • Location of the disorder
  • Severity of the disorder
  • Associated complications
  • Treatment plan

Supporting Evidence:

  • Clinical examination findings
  • Laboratory test results
  • Imaging results
  • Provider's clinical judgment
Good Documentation Example:

Patient diagnosed with severe plaque psoriasis on the elbows and knees. Treatment plan includes topical steroids and light therapy.

Poor Documentation Example:

Patient has a skin condition.

Common Documentation Errors:

  • Not documenting the specific type of disorder
  • Not documenting the location of the disorder
  • Not documenting associated complications
  • Not providing supporting evidence for the diagnosis

Range Statistics

6
Total Codes
22
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:12

Coding Complexity

Medium
Complexity Rating

Coding for papulosquamous disorders is of medium complexity due to the need to accurately identify the specific type and location of the disorder, code any associated complications, and use combination codes when appropriate. Coders must also stay current with any changes to the ICD-10 manual.

Key Factors:
  • Determining the specific type of disorder
  • Identifying the location of the disorder
  • Coding associated complications
  • Using combination codes
  • Staying current with changes to the ICD-10 manual

Specialty Focus

Papulosquamous disorders are most commonly encountered in dermatology, but may also be seen in primary care and rheumatology due to the systemic nature of some conditions.

Primary Specialties:
Dermatology
70%
Primary Care
20%
Rheumatology
10%
Clinical Scenarios:
  • Patient presents with a rash and is diagnosed with guttate psoriasis.
  • Patient with a history of psoriasis presents with joint pain and is diagnosed with psoriatic arthritis.
  • Patient presents with a lacy white rash on the mouth and is diagnosed with oral lichen planus.
  • Patient presents with a herald patch followed by a Christmas tree rash and is diagnosed with pityriasis rosea.

Resources & References

Resources for coding papulosquamous disorders include the ICD-10 manual, official coding guidelines, and clinical references.

Official Guidelines:

  • ICD-10-CM Official Guidelines for Coding and Reporting
  • American Health Information Management Association (AHIMA) guidelines
  • American Academy of Professional Coders (AAPC) guidelines

Clinical References:

  • American Academy of Dermatology (AAD) guidelines
  • UpToDate clinical database

Educational Materials:

  • ICD-10 coding training courses
  • Medical coding textbooks

Frequently Asked Questions

Can I use a code from the L40-L45 range if the patient's condition is suspected but not confirmed?

No, you should only use codes from this range if the patient's condition has been confirmed by the provider. If the condition is suspected but not confirmed, use a code to document the patient's symptoms instead.