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ICD-10 Guide
ICD-10 CodesL02.436

L02.436

Billable

Carbuncle of left lower limb

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

Code Description

ICD-10 L02.436 is a billable code used to indicate a diagnosis of carbuncle of left lower limb.

Key Diagnostic Point:

A carbuncle is a painful cluster of boils that are connected to each other under the skin, typically caused by bacterial infection, most commonly Staphylococcus aureus. The clinical presentation of a carbuncle includes a red, swollen area on the skin that may contain pus and is often accompanied by fever and malaise. In the case of L02.436, the carbuncle is specifically located on the left lower limb, which includes the thigh, leg, and foot. The disease progresses from a small, painful nodule to a larger, inflamed area that can rupture and drain pus. Diagnosis is primarily clinical, based on the appearance of the lesion and associated symptoms. Laboratory tests may be conducted to identify the causative organism, especially in recurrent cases. Differential diagnoses include folliculitis, abscess, and other skin infections. Prompt treatment is essential to prevent complications such as systemic infection or scarring, and may include incision and drainage, along with antibiotic therapy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possible laboratory tests.
  • Treatment complexity: May involve surgical intervention and antibiotic management.
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary.
  • Coding specificity: Requires precise localization of the carbuncle.

Audit Risk Factors

  • Common coding errors: Misidentification of the lesion type or location.
  • Documentation gaps: Incomplete clinical notes regarding the treatment plan.
  • Billing challenges: Potential denials if the documentation does not support the severity or treatment provided.

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: Infectious Disease

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

Carbuncles can significantly impact patient quality of life due to pain and potential systemic infection. They are more prevalent in certain populations, including those with diabetes or immunocompromised states. Understanding the epidemiology of skin infections like carbuncles can help healthcare providers implement effective prevention strategies and improve patient outcomes. Monitoring quality measures related to skin infections can also enhance healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

Carbuncles can significantly impact patient quality of life due to pain and potential systemic infection. They are more prevalent in certain populations, including those with diabetes or immunocompromised states. Understanding the epidemiology of skin infections like carbuncles can help healthcare providers implement effective prevention strategies and improve patient outcomes. Monitoring quality measures related to skin infections can also enhance healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and any associated antibiotic therapy. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical notes, treatment plans, and follow-up care are thoroughly documented to avoid billing challenges and ensure proper 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 L02.436?

L02.436 specifically covers carbuncles located on the left lower limb, which are characterized by multiple interconnected boils that may present with systemic symptoms such as fever. It is essential to differentiate this from other skin infections like abscesses or folliculitis.

When should L02.436 be used instead of related codes?

L02.436 should be used when the clinical presentation confirms a carbuncle on the left lower limb, particularly when there is evidence of multiple boils and systemic symptoms. Related codes may be used for carbuncles in other locations or for different types of skin infections.

What documentation supports L02.436?

Documentation should include a detailed description of the lesion, clinical findings, treatment provided, and any laboratory results. Notes should clearly indicate the location and nature of the carbuncle to support the use of L02.436.