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ICD-10 Guide
ICD-10 CodesL02.421

L02.421

Billable

Furuncle of right axilla

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

Code Description

ICD-10 L02.421 is a billable code used to indicate a diagnosis of furuncle of right axilla.

Key Diagnostic Point:

Furuncle of the right axilla, commonly known as a boil, is a painful, pus-filled bump that forms under the skin when hair follicles become infected. This condition is primarily caused by Staphylococcus aureus bacteria, which can enter the skin through small cuts or abrasions. The axilla, or armpit area, is particularly susceptible due to moisture and friction, making it a common site for furuncles. Clinically, patients present with localized swelling, redness, and tenderness, often accompanied by systemic symptoms such as fever if the infection is severe. Disease progression typically involves the formation of a painful nodule that may eventually rupture and drain pus. Diagnostic considerations include a thorough physical examination and, if necessary, culture of the pus to identify the causative organism. In some cases, underlying conditions such as diabetes or immunosuppression may predispose individuals to recurrent furuncles, necessitating further evaluation and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical evaluation and potential laboratory tests.
  • Treatment complexity: Moderate, as treatment may involve incision and drainage, antibiotics, and management of underlying conditions.
  • Documentation requirements: Moderate, necessitating detailed clinical notes and possibly culture results.
  • Coding specificity: High, as L02.421 specifically identifies the location and type of skin infection.

Audit Risk Factors

  • Common coding errors: Misidentifying the location or type of skin infection.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials if the documentation does not clearly justify the use of L02.421.

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

Primary Care

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Furuncles, while often self-limiting, can lead to significant discomfort and may result in complications if not treated appropriately. The incidence of skin infections like furuncles is notable in populations with compromised immune systems or poor hygiene practices. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve patient education, ultimately reducing healthcare utilization and enhancing population health outcomes.

ICD-9 vs ICD-10

Furuncles, while often self-limiting, can lead to significant discomfort and may result in complications if not treated appropriately. The incidence of skin infections like furuncles is notable in populations with compromised immune systems or poor hygiene practices. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve patient education, ultimately reducing healthcare utilization and enhancing population health outcomes.

Reimbursement & Billing Impact

Reimbursement may depend on the complexity of the case and the services rendered, such as incision and drainage (CPT codes 10060 or 10061). Common denials may arise from insufficient documentation or incorrect coding of the site. Best practices include ensuring that the medical record clearly supports the diagnosis and treatment plan, and that all relevant codes are accurately reported to avoid billing issues.

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 L02.421?

L02.421 specifically covers furuncles located in the right axilla. It is important to differentiate this from other skin infections such as carbuncles (L02.42) or abscesses (L02.9).

When should L02.421 be used instead of related codes?

L02.421 should be used when the furuncle is confirmed to be in the right axilla, as opposed to other locations or types of skin infections. Accurate localization is key for proper coding.

What documentation supports L02.421?

Documentation should include a detailed description of the lesion, its location, symptoms, treatment provided, and any laboratory results, such as cultures, that confirm the diagnosis.