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ICD-10 Guide
ICD-10 CodesL02.415

L02.415

Billable

Cutaneous abscess of right lower limb

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

Code Description

ICD-10 L02.415 is a billable code used to indicate a diagnosis of cutaneous abscess of right lower limb.

Key Diagnostic Point:

L02.415 refers to a cutaneous abscess located in the right lower limb, which is a localized collection of pus within the skin or subcutaneous tissue. Clinically, patients may present with symptoms such as localized swelling, redness, warmth, and tenderness in the affected area. The abscess may also be fluctuant, indicating the presence of pus beneath the skin. The anatomy involved primarily includes the dermis and subcutaneous tissue, which can become infected due to bacteria, often following trauma or as a complication of other skin conditions. Disease progression can lead to systemic symptoms such as fever if the infection spreads. Diagnostic considerations include physical examination findings and may involve imaging studies if deeper structures are suspected to be involved. Culturing the pus can help identify the causative organism, guiding appropriate antibiotic therapy. Timely intervention is crucial to prevent complications such as cellulitis or systemic infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical evaluation and possibly imaging.
  • Treatment complexity: Moderate, as it may involve incision and drainage along with antibiotic therapy.
  • Documentation requirements: Moderate, necessitating detailed clinical notes on symptoms and treatment.
  • Coding specificity: High, as it specifically identifies the location and type of abscess.

Audit Risk Factors

  • Common coding errors: Misidentification of the abscess location or type.
  • Documentation gaps: Insufficient detail on the clinical presentation or treatment plan.
  • Billing challenges: Potential denials if the 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: 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 L02.415 lies in its potential to lead to serious complications if not treated promptly, such as systemic infections or the need for surgical intervention. In terms of population health, cutaneous abscesses are common, particularly in individuals with compromised skin integrity or underlying health conditions. Quality measures may include monitoring infection rates and treatment outcomes, while healthcare utilization patterns may reflect the need for outpatient versus inpatient management based on the severity of the abscess.

ICD-9 vs ICD-10

The clinical significance of L02.415 lies in its potential to lead to serious complications if not treated promptly, such as systemic infections or the need for surgical intervention. In terms of population health, cutaneous abscesses are common, particularly in individuals with compromised skin integrity or underlying health conditions. Quality measures may include monitoring infection rates and treatment outcomes, while healthcare utilization patterns may reflect the need for outpatient versus inpatient management based on the severity of the abscess.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, which may require additional CPT codes. Common denials may arise from inadequate documentation or failure to demonstrate medical necessity. Best practices include thorough documentation of the clinical findings, treatment provided, and follow-up care to support the claim and reduce the risk of audits.

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 L02.415?

L02.415 specifically covers cutaneous abscesses in the right lower limb, which may arise from various causes including bacterial infections, trauma, or pre-existing skin conditions such as folliculitis or hidradenitis suppurativa.

When should L02.415 be used instead of related codes?

L02.415 should be used when the abscess is specifically located in the right lower limb, distinguishing it from other abscess codes that may not specify location or may pertain to other limbs or body areas.

What documentation supports L02.415?

Documentation should include a detailed clinical assessment of the abscess, including its size, location, symptoms, treatment provided, and any laboratory results from cultures or imaging studies.