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ICD-10 Guide
ICD-10 CodesL02.53

L02.53

Non-billable

Carbuncle of hand

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

Code Description

ICD-10 L02.53 is a used to indicate a diagnosis of carbuncle of hand.

Key Diagnostic Point:

A carbuncle of the hand is a painful cluster of boils that forms when hair follicles become infected, typically caused by Staphylococcus aureus bacteria. Clinically, it presents as a red, swollen area on the skin that may be filled with pus and is often accompanied by systemic symptoms such as fever and malaise. The anatomy involved includes the skin and subcutaneous tissue of the hand, where the infection can lead to significant inflammation and tissue necrosis if not treated promptly. Disease progression can vary; in some cases, the carbuncle may resolve spontaneously, while in others, it may require surgical intervention for drainage. Diagnostic considerations include a thorough physical examination and, if necessary, culture of the pus to identify the causative organism. Differential diagnoses may include other skin infections such as abscesses or folliculitis, making accurate coding essential for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes laboratory tests.
  • Treatment complexity: May involve antibiotics and surgical drainage.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential.
  • Coding specificity: Requires precise coding to differentiate from similar conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin infections.
  • Documentation gaps: Incomplete records of symptoms or treatment.
  • Billing challenges: Potential denials if 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

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of carbuncles, particularly in the hand, lies in their potential to cause significant discomfort and functional impairment. Population health impact includes the need for effective management to prevent complications such as systemic infection. Quality measures may focus on timely diagnosis and treatment, while healthcare utilization patterns can reflect the frequency of visits for skin infections. Epidemiologically, carbuncles are more common in individuals with compromised immune systems or poor hygiene practices.

ICD-9 vs ICD-10

The clinical significance of carbuncles, particularly in the hand, lies in their potential to cause significant discomfort and functional impairment. Population health impact includes the need for effective management to prevent complications such as systemic infection. Quality measures may focus on timely diagnosis and treatment, while healthcare utilization patterns can reflect the frequency of visits for skin infections. Epidemiologically, carbuncles are more common in individuals with compromised immune systems or poor hygiene practices.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as drainage of the carbuncle, and the necessity of any follow-up visits. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedure. Best practices include ensuring that all clinical notes are complete and that the coding accurately reflects the services rendered.

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 L02.53?

L02.53 specifically covers carbuncles located on the hand, which are characterized by multiple interconnected boils resulting from bacterial infection of hair follicles.

When should L02.53 be used instead of related codes?

L02.53 should be used when the carbuncle is specifically located on the hand, distinguishing it from carbuncles on other body parts, which have different codes.

What documentation supports L02.53?

Documentation should include a detailed description of the lesion, symptoms experienced by the patient, any treatments administered, and follow-up care plans.