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ICD-10 Guide
ICD-10 CodesL02.425

L02.425

Billable

Furuncle of right lower limb

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

Code Description

ICD-10 L02.425 is a billable code used to indicate a diagnosis of furuncle of right lower limb.

Key Diagnostic Point:

Furuncle of the right lower limb, commonly known as a boil, is a painful, pus-filled bump that forms under the skin due to a bacterial infection, typically caused by Staphylococcus aureus. Clinically, it presents as a red, swollen area that may be tender to touch and can develop a central necrotic area with a yellow or white head. The furuncle can occur anywhere on the body but is particularly common in areas where friction or sweating occurs, such as the thighs or calves. The disease progression often begins with a small, painful nodule that can enlarge and become more painful over several days. In some cases, multiple furuncles can cluster together, forming a carbuncle. Diagnostic considerations include a thorough clinical examination and, if necessary, culture of the pus to identify the causative organism. Treatment typically involves warm compresses to promote drainage, and in some cases, incision and drainage may be required. Antibiotics may be prescribed if there is systemic involvement or if the furuncle is recurrent.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical evaluation and sometimes laboratory confirmation.
  • Treatment complexity: Moderate, as it may require both conservative and surgical interventions.
  • Documentation requirements: Requires detailed documentation of clinical findings and treatment plans.
  • Coding specificity: High, as it specifies the location and type of skin infection.

Audit Risk Factors

  • Common coding errors: Misidentifying the location or type of infection.
  • Documentation gaps: Incomplete clinical notes regarding the size, drainage, or treatment of the furuncle.
  • Billing challenges: Difficulty in justifying the need for surgical intervention or antibiotic therapy.

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

Furuncles can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. They are common in certain populations, particularly those with compromised immune systems or poor hygiene. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve patient education on skin care, ultimately reducing the incidence of these infections.

ICD-9 vs ICD-10

Furuncles can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. They are common in certain populations, particularly those with compromised immune systems or poor hygiene. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve patient education on skin care, ultimately reducing the incidence of these infections.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, whether it was a simple drainage or required more extensive surgical intervention. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures. It is essential to ensure that all relevant details are captured in the medical record to support the coding and billing process.

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 L02.425?

L02.425 specifically covers furuncles located on the right lower limb, which are localized skin infections characterized by painful, pus-filled nodules. It does not cover other types of skin infections or lesions.

When should L02.425 be used instead of related codes?

L02.425 should be used when documenting a furuncle specifically on the right lower limb. If the lesion is on a different limb or if it is a different type of skin infection, other codes such as L02.41 or L02.42 should be considered.

What documentation supports L02.425?

Documentation should include a detailed description of the lesion, including size, location, symptoms, treatment provided, and any laboratory results if applicable. Clinical notes should clearly indicate the diagnosis of a furuncle.