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ICD-10 Guide
ICD-10 CodesL02.531

L02.531

Billable

Carbuncle of right hand

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

Code Description

ICD-10 L02.531 is a billable code used to indicate a diagnosis of carbuncle of right hand.

Key Diagnostic Point:

A carbuncle is a cluster of interconnected furuncles (boils) that form a painful, pus-filled infection in the skin and subcutaneous tissue. The condition typically presents as a red, swollen area that may have multiple openings from which pus can drain. In the case of a carbuncle of the right hand, the infection may involve the hair follicles and surrounding tissue, leading to significant discomfort and potential systemic symptoms such as fever. The anatomy involved includes the epidermis, dermis, and subcutaneous layers of the skin, particularly in areas with hair follicles. Disease progression can vary; if untreated, a carbuncle may lead to further infection or abscess formation. Diagnostic considerations include a thorough clinical examination and, if necessary, cultures to identify the causative organism, often Staphylococcus aureus. Treatment typically involves incision and drainage, along with antibiotics if systemic symptoms are present or if the infection is extensive.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly laboratory tests to confirm infection.
  • Treatment complexity: May involve surgical intervention and antibiotic therapy.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis and treatment.
  • Coding specificity: Requires precise coding to differentiate from other skin infections.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin infections or abscesses.
  • Documentation gaps: Insufficient detail in clinical notes regarding the extent of the infection.
  • Billing challenges: Potential denials if the documentation does not clearly 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

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 complications. They are more prevalent in populations with risk factors such as diabetes or immunocompromised states. Understanding the epidemiology of carbuncles can help healthcare providers implement preventive measures and improve patient outcomes. Monitoring the incidence of such infections can also inform public health strategies aimed at reducing skin and soft tissue infections.

ICD-9 vs ICD-10

Carbuncles can significantly impact patient quality of life due to pain and potential complications. They are more prevalent in populations with risk factors such as diabetes or immunocompromised states. Understanding the epidemiology of carbuncles can help healthcare providers implement preventive measures and improve patient outcomes. Monitoring the incidence of such infections can also inform public health strategies aimed at reducing skin and soft tissue infections.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and whether antibiotics were prescribed. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include thorough clinical notes, clear descriptions of the procedure, and ensuring that the diagnosis correlates with the services billed.

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 L02.531?

L02.531 specifically covers carbuncles located on the right hand, which are characterized by painful, pus-filled infections of the skin and subcutaneous tissue. It is important to differentiate this from other skin infections such as abscesses or cellulitis.

When should L02.531 be used instead of related codes?

L02.531 should be used when the clinical presentation specifically indicates a carbuncle on the right hand. If the infection is located elsewhere or is unspecified, other codes such as L02.529 may be more appropriate.

What documentation supports L02.531?

Documentation should include a detailed clinical examination, description of the lesion, any systemic symptoms, and treatment provided. Photographic evidence may also be beneficial in complex cases.