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ICD-10 Guide
ICD-10 CodesL02.03

L02.03

Billable

Carbuncle of face

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

Code Description

ICD-10 L02.03 is a billable code used to indicate a diagnosis of carbuncle of face.

Key Diagnostic Point:

A carbuncle of the face is a painful cluster of boils that forms when multiple hair follicles become infected, leading to the formation of a deep, pus-filled abscess. Clinically, it presents as a red, swollen area on the face, often accompanied by fever and malaise. The condition typically arises from bacterial infections, most commonly Staphylococcus aureus, and can occur in individuals with compromised immune systems or poor hygiene. The disease progresses from a small, tender nodule to a larger, fluctuant mass that may drain spontaneously or require surgical intervention. Diagnostic considerations include a thorough clinical examination, history-taking to identify risk factors, and, if necessary, culture of the pus to determine the causative organism. Treatment often involves incision and drainage, along with antibiotics if systemic symptoms are present or if the infection is extensive. Proper management is crucial to prevent complications such as cellulitis or systemic spread of infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

Specialty Focus

Medical Specialties

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

Primary Care

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

Carbuncles, particularly on the face, can significantly impact a patient's quality of life, leading to pain, disfigurement, and psychological distress. They are more prevalent in populations with higher rates of skin infections, such as those with diabetes or immunocompromised states. Understanding the epidemiology of carbuncles can help healthcare providers implement preventive measures and improve patient outcomes, ultimately reducing healthcare utilization and associated costs.

ICD-9 vs ICD-10

Carbuncles, particularly on the face, can significantly impact a patient's quality of life, leading to pain, disfigurement, and psychological distress. They are more prevalent in populations with higher rates of skin infections, such as those with diabetes or immunocompromised states. Understanding the epidemiology of carbuncles can help healthcare providers implement preventive measures and improve patient outcomes, ultimately reducing healthcare utilization and associated costs.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure, the need for surgical intervention, and the use of antibiotics. Common denials may arise from insufficient documentation or incorrect coding. It is essential to provide clear clinical notes that justify the diagnosis and treatment provided, ensuring compliance with payer requirements. Best practices include verifying insurance coverage for procedures and maintaining thorough records of patient interactions and treatment plans.

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 L02.03?

L02.03 specifically covers carbuncles located on the face, which are characterized by multiple interconnected boils that arise from infected hair follicles. It is important to differentiate this from other skin infections such as furuncles (boils) or cellulitis.

When should L02.03 be used instead of related codes?

L02.03 should be used when the infection is specifically located on the face. If the infection is on another part of the body, such as the neck or trunk, the corresponding codes (L02.01 or L02.02) should be utilized.

What documentation supports L02.03?

Documentation should include a detailed clinical examination, patient history, treatment plan, and any laboratory results, such as cultures, that confirm the diagnosis of a carbuncle on the face.