ICD-10 Guide

Pilonidal Cyst

ICD-10 Coding for Pilonidal Cyst(L05.01, L05.02, L05.91, L05.92)

PRIMARY SPECIALTYColorectal Surgery

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Pilonidal Cyst?

Essential facts and insights about Pilonidal Cyst

Key Clinical Considerations:

Pain and swelling in the sacrococcygeal area
Presence of a sinus tract or abscess
Discharge of pus or blood from the cyst

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history of recurrent cysts or abscesses
Description of physical exam findings including location and size
Details of any previous treatments or surgeries

Coding Guidelines

Usage Guidelines & Examples

Follow guidelines for coding based on the presence of infection or abscess.
Common errors include misclassifying the cyst as a different type of skin lesion.

Code Exclusions

Important Exclusions

Other types of cysts such as sebaceous cysts
Codes for pilonidal disease without cyst formation

Specialty Focus

Primary Specialty

Colorectal Surgery

Specialty Applications

Young adults, particularly males aged 15-30
Outpatient and inpatient surgical settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document the patient's symptoms, physical exam findings, and any imaging results.

What are the billing considerations?

Ensure accurate coding based on the severity and treatment provided.

Pilonidal Cyst

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?

Pilonidal Cyst

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?