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ICD-10 Guide
ICD-10 CodesL02.413

L02.413

Billable

Cutaneous abscess of right upper limb

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

Code Description

ICD-10 L02.413 is a billable code used to indicate a diagnosis of cutaneous abscess of right upper limb.

Key Diagnostic Point:

L02.413 refers to a cutaneous abscess located in the right upper limb, which is a localized collection of pus within the dermis or subcutaneous tissue. Clinically, patients may present with symptoms such as swelling, redness, warmth, and tenderness in the affected area, often accompanied by systemic signs of infection like fever. The anatomy involved includes the skin layers (epidermis, dermis) and the subcutaneous tissue, where the abscess forms due to bacterial infection, often stemming from hair follicles, sebaceous glands, or trauma. Disease progression can lead to complications if not treated, including cellulitis or systemic infection. Diagnostic considerations include physical examination, imaging studies (like ultrasound), and laboratory tests (such as cultures) to identify the causative organism. Proper identification of the abscess location and characteristics is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors include misidentifying the location of the abscess.
  • Documentation gaps may arise if the clinical notes do not clearly describe the abscess characteristics.
  • Billing challenges can occur if the treatment provided does not align with the documented diagnosis.

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 L02.413 lies in its potential to lead to serious infections if not treated promptly. Population health impact includes the need for effective management of skin infections to prevent complications. Quality measures may focus on timely treatment and follow-up care for abscesses. Healthcare utilization patterns show that abscesses are common presentations in emergency departments and outpatient settings, highlighting the importance of accurate coding and documentation for effective resource allocation.

ICD-9 vs ICD-10

The clinical significance of L02.413 lies in its potential to lead to serious infections if not treated promptly. Population health impact includes the need for effective management of skin infections to prevent complications. Quality measures may focus on timely treatment and follow-up care for abscesses. Healthcare utilization patterns show that abscesses are common presentations in emergency departments and outpatient settings, highlighting the importance of accurate coding and documentation for effective resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the abscess and the treatment provided. Documentation must support the medical necessity of the procedure, including the size and severity of the abscess. Common denials may arise from insufficient documentation or coding errors, particularly if the abscess location is not clearly stated. Best practices include ensuring that all clinical notes are thorough and that the procedure codes align with the diagnosis.

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 L02.413?

L02.413 specifically covers cutaneous abscesses located in the right upper limb. This includes abscesses arising from folliculitis, furuncles, or post-traumatic infections. It is important to differentiate it from other skin infections such as cellulitis or necrotizing fasciitis.

When should L02.413 be used instead of related codes?

L02.413 should be used when the abscess is specifically located in the right upper limb. If the abscess is in another location, such as the left upper limb or another body part, the corresponding codes (e.g., L02.412) should be utilized. Accurate documentation of the abscess's location is essential for proper code selection.

What documentation supports L02.413?

Documentation should include a detailed description of the abscess's location, size, and characteristics, as well as any associated symptoms. Clinical notes should also reflect the treatment provided, such as incision and drainage, and any cultures taken to identify the causative organism.