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ICD-10 Guide
ICD-10 CodesL02.236

L02.236

Billable

Carbuncle of umbilicus

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

Code Description

ICD-10 L02.236 is a billable code used to indicate a diagnosis of carbuncle of umbilicus.

Key Diagnostic Point:

A carbuncle of the umbilicus is a painful, pus-filled infection that occurs in the skin and subcutaneous tissue around the navel. It typically presents as a cluster of boils, which are red, swollen, and tender nodules that can merge to form a larger lesion. The condition is caused by bacterial infection, most commonly Staphylococcus aureus, and can be exacerbated by factors such as poor hygiene, obesity, and diabetes. The disease progression may start with localized pain and swelling, followed by the formation of abscesses that can drain pus. Diagnosis is primarily clinical, based on the characteristic appearance of the lesion and patient history. In some cases, cultures may be taken to identify the causative organism. Treatment often involves incision and drainage of the carbuncle, along with antibiotics if systemic infection is suspected. Proper wound care and hygiene are essential to prevent recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes laboratory tests.
  • Treatment complexity: May involve surgical intervention and antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other skin infections.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin infections.
  • Documentation gaps: Incomplete clinical notes regarding the extent of the infection.
  • Billing challenges: Denials may occur if the documentation does not support the severity or treatment provided.

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

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, including those at the umbilicus, can significantly impact patient quality of life due to pain and discomfort. They may lead to increased healthcare utilization, including emergency visits and surgical interventions. Understanding the epidemiology of skin infections, particularly in populations with risk factors like diabetes or obesity, is essential for public health initiatives aimed at prevention and education.

ICD-9 vs ICD-10

Carbuncles, including those at the umbilicus, can significantly impact patient quality of life due to pain and discomfort. They may lead to increased healthcare utilization, including emergency visits and surgical interventions. Understanding the epidemiology of skin infections, particularly in populations with risk factors like diabetes or obesity, is essential for public health initiatives aimed at prevention and education.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the procedure performed, such as incision and drainage. Common denials can arise from insufficient documentation or incorrect coding. It is advisable to include detailed notes on the clinical presentation, treatment rationale, and follow-up care to mitigate these risks. Familiarity with payer-specific guidelines can also enhance the billing process.

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 L02.236?

L02.236 specifically covers carbuncles located at the umbilicus, which are characterized by multiple interconnected boils and localized infection. It does not include other types of skin infections or lesions.

When should L02.236 be used instead of related codes?

L02.236 should be used when the carbuncle is specifically located at the umbilicus. If the infection occurs in other areas, such as the neck or back, different codes like L02.23 should be utilized.

What documentation supports L02.236?

Documentation should include a detailed description of the lesion, clinical findings, treatment provided, and any laboratory results if cultures were taken. It is important to note the patient's history and any underlying conditions that may contribute to the infection.