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ICD-10 Guide
ICD-10 CodesL02.419

L02.419

Billable

Cutaneous abscess of limb, unspecified

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

Code Description

ICD-10 L02.419 is a billable code used to indicate a diagnosis of cutaneous abscess of limb, unspecified.

Key Diagnostic Point:

L02.419 refers to a cutaneous abscess located in the limb, unspecified. A cutaneous abscess is a localized collection of pus within the dermis or subcutaneous tissue, typically resulting from infection. Clinically, patients may present with symptoms such as localized swelling, redness, warmth, and tenderness in the affected area. The abscess may be fluctuant, indicating the presence of pus, and may require drainage for resolution. The anatomy involved primarily includes the skin layers (epidermis, dermis) and the subcutaneous tissue, which houses blood vessels, nerves, and connective tissue. Disease progression can vary; if untreated, an abscess may lead to systemic infection or complications such as cellulitis. Diagnostic considerations include physical examination, patient history, and possibly imaging studies to assess the extent of the abscess. Laboratory tests may be performed to identify the causative organism, particularly in recurrent cases or when systemic symptoms are present.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes imaging.
  • Treatment complexity: May involve incision and drainage, antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary.
  • Coding specificity: Requires accurate identification of the abscess location.

Audit Risk Factors

  • Common coding errors: Misidentifying the location or type of abscess.
  • Documentation gaps: Incomplete clinical notes regarding the abscess characteristics.
  • Billing challenges: Potential denials if the documentation does not support the 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 L02.419 lies in its potential to indicate underlying infections that may affect overall health. Cutaneous abscesses can lead to increased healthcare utilization due to the need for surgical intervention and follow-up care. Understanding the epidemiology of abscesses can help healthcare providers implement preventive measures, particularly in populations at higher risk for skin infections, such as those with diabetes or immunocompromised states.

ICD-9 vs ICD-10

The clinical significance of L02.419 lies in its potential to indicate underlying infections that may affect overall health. Cutaneous abscesses can lead to increased healthcare utilization due to the need for surgical intervention and follow-up care. Understanding the epidemiology of abscesses can help healthcare providers implement preventive measures, particularly in populations at higher risk for skin infections, such as those with diabetes or immunocompromised states.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and any associated costs for laboratory tests. Common denials may arise from insufficient documentation or failure to provide a clear rationale for the procedure. Best practices include thorough clinical notes, accurate coding of the procedure, and timely submission of claims to avoid delays in reimbursement.

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 L02.419?

L02.419 covers unspecified cutaneous abscesses of the limb, which may arise from bacterial infections, foreign bodies, or other underlying conditions. It does not specify the causative organism or the exact location within the limb.

When should L02.419 be used instead of related codes?

L02.419 should be used when the abscess location is not specified or when the clinician is unable to determine the exact site of the abscess. If the abscess is localized to a specific limb (right or left), the more specific codes L02.411 or L02.412 should be used.

What documentation supports L02.419?

Documentation should include a thorough clinical examination, details of the abscess characteristics (size, fluctuation), treatment provided (e.g., drainage), and any laboratory results if applicable. Clear notes on the patient's history and any relevant comorbidities are also essential.