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ICD-10 Guide
ICD-10 CodesL02.232

L02.232

Billable

Carbuncle of back [any part, except buttock]

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

Code Description

ICD-10 L02.232 is a billable code used to indicate a diagnosis of carbuncle of back [any part, except buttock].

Key Diagnostic Point:

A carbuncle is a painful cluster of boils that are typically caused by bacterial infection, most commonly Staphylococcus aureus. The condition manifests as a red, swollen area on the skin, often accompanied by pus-filled lesions. In the case of a carbuncle of the back, the lesions can occur anywhere on the upper or lower back, excluding the buttocks. The skin and subcutaneous tissue are primarily involved, leading to inflammation and potential necrosis if left untreated. Patients may experience fever, malaise, and localized pain. Disease progression can vary; if untreated, carbuncles may lead to systemic infection or abscess formation. Diagnosis is primarily clinical, based on physical examination and patient history. Laboratory tests may be conducted to identify the causative organism, especially in recurrent cases. Differential diagnoses include furuncles, hidradenitis suppurativa, and other skin infections. Early recognition and treatment are crucial to prevent complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and potential lab tests.
  • Treatment complexity: May involve antibiotics, drainage, and wound care.
  • Documentation requirements: Detailed patient history and clinical findings are necessary.
  • Coding specificity: Requires accurate identification of the site and type of infection.

Audit Risk Factors

  • Common coding errors: Misidentifying the site of the carbuncle.
  • Documentation gaps: Incomplete patient history or lack of clinical findings.
  • Billing challenges: Denials may occur 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: Infectious Disease

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 can significantly impact patient health, leading to pain, discomfort, and potential systemic infections. Understanding the epidemiology of skin infections, including carbuncles, is crucial for public health initiatives aimed at reducing bacterial infections. Quality measures may include tracking the incidence of skin infections and the effectiveness of treatment protocols. Increased healthcare utilization patterns may arise from complications associated with untreated carbuncles, highlighting the importance of early diagnosis and intervention.

ICD-9 vs ICD-10

Carbuncles can significantly impact patient health, leading to pain, discomfort, and potential systemic infections. Understanding the epidemiology of skin infections, including carbuncles, is crucial for public health initiatives aimed at reducing bacterial infections. Quality measures may include tracking the incidence of skin infections and the effectiveness of treatment protocols. Increased healthcare utilization patterns may arise from complications associated with untreated carbuncles, highlighting the importance of early diagnosis and intervention.

Reimbursement & Billing Impact

Reimbursement may depend on the specificity of the diagnosis and the treatment provided. Common denials can arise from insufficient documentation or incorrect coding. It is advisable to include details about the size, location, and treatment of the carbuncle, as well as any associated symptoms. Proper coding practices include using the most specific code available and ensuring that the medical necessity for any procedures performed is well documented.

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 L02.232?

L02.232 specifically covers carbuncles located on the back, which are characterized by multiple interconnected furuncles and may present with systemic symptoms. It does not include isolated furuncles or carbuncles located on the buttocks.

When should L02.232 be used instead of related codes?

L02.232 should be used when the carbuncle is specifically located on the back. If the lesion is on the buttocks, L02.231 should be used. Accurate anatomical documentation is essential for correct coding.

What documentation supports L02.232?

Documentation should include a detailed clinical examination, patient history indicating symptoms such as pain and fever, and any laboratory results confirming the diagnosis. Photographic evidence may also support the clinical findings.