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ICD-10 Guide
ICD-10 CodesL02.81

L02.81

Non-billable

Cutaneous abscess of other sites

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

Code Description

ICD-10 L02.81 is a used to indicate a diagnosis of cutaneous abscess of other sites.

Key Diagnostic Point:

L02.81 refers to cutaneous abscesses located at sites other than the commonly affected areas such as the axilla, groin, or perineum. These abscesses are localized collections of pus that occur within the dermis and subcutaneous tissue, often resulting from bacterial infections, particularly Staphylococcus aureus. Clinically, patients may present with symptoms including localized swelling, redness, warmth, and tenderness at the site of the abscess. The abscess may fluctuate, indicating the presence of pus, and can be associated with systemic symptoms such as fever and malaise. The disease progression typically involves the formation of a painful nodule that can rupture, leading to drainage of purulent material. Diagnostic considerations include a thorough physical examination and, if necessary, imaging studies to assess the extent of the abscess. Culturing the pus can help identify the causative organism and guide appropriate antibiotic therapy. Treatment often involves incision and drainage, along with antibiotic therapy based on culture results. Proper management is crucial to prevent complications such as cellulitis or systemic infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as differential diagnoses may include other skin infections.
  • Treatment complexity: Moderate, requiring both procedural and pharmacological interventions.
  • Documentation requirements: Requires detailed documentation of clinical findings and treatment.
  • Coding specificity: Specific to abscesses at non-standard sites, necessitating careful coding.

Audit Risk Factors

  • Common coding errors: Misidentification of abscess type or site.
  • Documentation gaps: Incomplete records of clinical findings or treatment plans.
  • Billing challenges: Potential denials due to lack of specificity in documentation.

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

Cutaneous abscesses, including those coded as L02.81, have significant clinical implications, as they can lead to complications such as cellulitis or systemic infections if not treated promptly. Understanding the epidemiology of these conditions can help healthcare providers implement preventive measures, particularly in populations at higher risk. Quality measures may include tracking the incidence of abscesses and the effectiveness of treatment protocols, which can influence healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

Cutaneous abscesses, including those coded as L02.81, have significant clinical implications, as they can lead to complications such as cellulitis or systemic infections if not treated promptly. Understanding the epidemiology of these conditions can help healthcare providers implement preventive measures, particularly in populations at higher risk. Quality measures may include tracking the incidence of abscesses and the effectiveness of treatment protocols, which can influence healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of detailed clinical notes that justify the need for incision and drainage, as well as any associated antibiotic therapy. Common denials may arise from insufficient documentation or failure to provide evidence of medical necessity. Coders should ensure that all relevant CPT codes are accurately linked to the diagnosis 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 L02.81?

L02.81 covers cutaneous abscesses located at various sites not specified elsewhere in the ICD-10 coding system. This includes abscesses that may arise from insect bites, foreign bodies, or other localized infections that do not fit into more specific categories.

When should L02.81 be used instead of related codes?

L02.81 should be used when the abscess is located at a site not specifically categorized under other codes, such as L02.0 or L02.2. It is important to ensure that the documentation clearly indicates the site and nature of the abscess.

What documentation supports L02.81?

Documentation should include a detailed description of the abscess location, size, symptoms, and any diagnostic tests performed. Additionally, records of treatment provided, including incision and drainage notes, and any cultures taken should be included.