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ICD-10 Guide
ICD-10 CodesL01.01

L01.01

Billable

Non-bullous impetigo

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 L01.01 is a billable code used to indicate a diagnosis of non-bullous impetigo.

Key Diagnostic Point:

Non-bullous impetigo is a highly contagious bacterial skin infection primarily caused by Staphylococcus aureus and Streptococcus pyogenes. Clinically, it presents as erythematous macules that evolve into vesicles or pustules, which subsequently rupture, leading to the formation of honey-colored crusts. The lesions are typically found on exposed areas of the skin, such as the face, arms, and legs, and are more common in children but can occur in adults as well. The disease progression is generally rapid, with lesions appearing within days of exposure. Diagnosis is primarily clinical, based on the characteristic appearance of the lesions, but can be confirmed through culture or PCR testing if necessary. Differential diagnoses include bullous impetigo, contact dermatitis, and other vesicular skin conditions. Prompt diagnosis and treatment are essential to prevent complications and the spread of infection, particularly in communal settings such as schools and daycare centers.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as clinical presentation is often distinctive but may require differentiation from other skin conditions.
  • Treatment complexity: Low, typically managed with topical or oral antibiotics.
  • Documentation requirements: Moderate, necessitating clear documentation of clinical findings and treatment plans.
  • Coding specificity: Medium, as it requires accurate identification of the specific type of impetigo.

Audit Risk Factors

  • Common coding errors: Misclassification of impetigo types.
  • Documentation gaps: Incomplete clinical notes regarding lesion characteristics.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: Dermatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Pediatrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Non-bullous impetigo significantly affects pediatric populations, leading to increased healthcare utilization due to its contagious nature. The condition can result in missed school days and increased parental work absences. Understanding its epidemiology is essential for public health initiatives aimed at reducing transmission in community settings. Quality measures may include tracking incidence rates and ensuring timely treatment to prevent complications.

ICD-9 vs ICD-10

Non-bullous impetigo significantly affects pediatric populations, leading to increased healthcare utilization due to its contagious nature. The condition can result in missed school days and increased parental work absences. Understanding its epidemiology is essential for public health initiatives aimed at reducing transmission in community settings. Quality measures may include tracking incidence rates and ensuring timely treatment to prevent complications.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical findings and that the treatment aligns with established guidelines. Common denials may arise from insufficient documentation or incorrect coding. It is crucial to verify insurance policies regarding coverage for antibiotic treatments, as some plans may have specific requirements.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by L01.01?

L01.01 specifically covers non-bullous impetigo, characterized by crusted lesions without the presence of large blisters. It is important to differentiate it from bullous impetigo (L01.02) and other skin infections.

When should L01.01 be used instead of related codes?

L01.01 should be used when the clinical presentation is consistent with non-bullous impetigo, particularly when lesions are crusted without significant blistering. If blisters are present, L01.02 should be considered.

What documentation supports L01.01?

Documentation should include a detailed description of the lesions, their location, duration, and any associated symptoms. Treatment plans and follow-up notes are also essential to support the diagnosis.