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ICD-10 Guide
ICD-10 CodesL02.213

L02.213

Billable

Cutaneous abscess of chest wall

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

Code Description

ICD-10 L02.213 is a billable code used to indicate a diagnosis of cutaneous abscess of chest wall.

Key Diagnostic Point:

L02.213 refers to a cutaneous abscess located on the chest wall, which is a localized collection of pus within the dermis or subcutaneous tissue. Clinically, patients may present with symptoms such as localized swelling, redness, warmth, and tenderness over the affected area. The abscess may also be fluctuant, indicating the presence of pus beneath the skin. The chest wall comprises skin, subcutaneous tissue, and underlying structures, making it susceptible to infections that can lead to abscess formation. Common causes include bacterial infections, often due to Staphylococcus aureus, and can arise from skin trauma, insect bites, or pre-existing skin conditions. Disease progression typically involves the initial inflammatory response, followed by the accumulation of pus and, if untreated, can lead to systemic symptoms like fever and malaise. Diagnostic considerations include physical examination and, if necessary, imaging studies to assess the extent of the abscess. Culturing the pus can help identify the causative organism and guide antibiotic therapy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve incision and drainage, along with antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and possibly lab results needed.
  • Coding specificity: Requires accurate identification of the abscess location.

Audit Risk Factors

  • Common coding errors: Misidentification of the abscess location or type.
  • Documentation gaps: Incomplete clinical notes regarding the abscess characteristics.
  • Billing challenges: Issues with justifying the need for surgical intervention or antibiotic therapy.

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

General Surgery

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

The clinical significance of L02.213 lies in its potential to cause discomfort and systemic infection if left untreated. In terms of population health, cutaneous abscesses are common and can lead to increased healthcare utilization due to complications. Quality measures may include timely intervention and appropriate antibiotic stewardship to prevent resistance. Epidemiologically, the incidence of skin infections, including abscesses, can vary based on factors such as geography, socioeconomic status, and underlying health conditions.

ICD-9 vs ICD-10

The clinical significance of L02.213 lies in its potential to cause discomfort and systemic infection if left untreated. In terms of population health, cutaneous abscesses are common and can lead to increased healthcare utilization due to complications. Quality measures may include timely intervention and appropriate antibiotic stewardship to prevent resistance. Epidemiologically, the incidence of skin infections, including abscesses, can vary based on factors such as geography, socioeconomic status, and underlying health conditions.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and any associated costs for laboratory tests. Common denials may arise from insufficient documentation or lack of medical necessity for the procedure. Best practices include thorough documentation of the clinical findings, treatment rationale, and follow-up care to support the claim.

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 L02.213?

L02.213 specifically covers cutaneous abscesses on the chest wall, which may arise from various causes including bacterial infections, trauma, or other skin conditions. It does not cover abscesses located in other anatomical areas.

When should L02.213 be used instead of related codes?

L02.213 should be used when the abscess is specifically located on the chest wall. If the abscess is located elsewhere, such as the abdomen or limbs, the appropriate code should be selected based on the specific location.

What documentation supports L02.213?

Documentation should include a detailed description of the abscess, including its size, location, symptoms, and any relevant history. Clinical notes should also indicate the treatment provided, such as incision and drainage, and any cultures taken.