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ICD-10 Guide
ICD-10 CodesL02.3

L02.3

Non-billable

Cutaneous abscess, furuncle and carbuncle of buttock

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

Code Description

ICD-10 L02.3 is a used to indicate a diagnosis of cutaneous abscess, furuncle and carbuncle of buttock.

Key Diagnostic Point:

L02.3 refers to cutaneous abscesses, furuncles, and carbuncles specifically located on the buttock. These conditions are characterized by localized collections of pus within the dermis and subcutaneous tissue, often resulting from bacterial infections, most commonly Staphylococcus aureus. Clinically, patients may present with painful, swollen areas that are red and warm to the touch. Furuncles (boils) are single, painful nodules, while carbuncles are larger, more severe infections that involve multiple hair follicles and can lead to systemic symptoms such as fever. The buttock region is particularly susceptible due to friction, moisture, and the presence of hair follicles. Diagnosis is primarily clinical, based on physical examination, although cultures may be obtained to identify the causative organism. Disease progression can lead to complications such as cellulitis or systemic infection if left untreated. Treatment typically involves incision and drainage of the abscess, along with antibiotics if systemic symptoms are present. Proper identification and management are crucial to prevent recurrence and complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate; requires clinical evaluation and sometimes laboratory confirmation.
  • Treatment complexity: Moderate; may involve surgical intervention and antibiotic therapy.
  • Documentation requirements: Requires detailed clinical notes and possibly imaging or culture results.
  • Coding specificity: Specific to abscesses, furuncles, and carbuncles on the buttock.

Audit Risk Factors

  • Common coding errors: Misclassification of abscess types or locations.
  • Documentation gaps: Insufficient detail on the extent of the infection or treatment provided.
  • Billing challenges: Denials may occur if documentation does not support the severity or treatment of the condition.

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: 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of L02.3 lies in its potential to cause discomfort and systemic infection if not managed appropriately. In terms of population health, these conditions can lead to increased healthcare utilization due to complications and recurrent infections. Quality measures may include timely intervention and appropriate antibiotic use, while epidemiological considerations highlight the prevalence of skin infections in various demographics, particularly in areas with limited access to healthcare.

ICD-9 vs ICD-10

The clinical significance of L02.3 lies in its potential to cause discomfort and systemic infection if not managed appropriately. In terms of population health, these conditions can lead to increased healthcare utilization due to complications and recurrent infections. Quality measures may include timely intervention and appropriate antibiotic use, while epidemiological considerations highlight the prevalence of skin infections in various demographics, particularly in areas with limited access to healthcare.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and whether antibiotics were prescribed. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedure. It is essential to ensure that all relevant details are captured in the medical record to support the coding and billing process effectively.

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 L02.3?

L02.3 covers cutaneous abscesses, furuncles, and carbuncles specifically located on the buttock. These conditions are characterized by localized infections that can cause pain, swelling, and systemic symptoms if severe.

When should L02.3 be used instead of related codes?

L02.3 should be used when the abscess, furuncle, or carbuncle is specifically located on the buttock. If the infection is located elsewhere, such as the face or neck, other codes like L02.1 or L02.2 should be utilized.

What documentation supports L02.3?

Documentation should include a detailed clinical examination note describing the size, location, and characteristics of the lesion, any associated symptoms, and the treatment provided, including any surgical interventions or antibiotic prescriptions.