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ICD-10 Guide
ICD-10 CodesL02.831

L02.831

Billable

Carbuncle of head [any part, except face]

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

Code Description

ICD-10 L02.831 is a billable code used to indicate a diagnosis of carbuncle of head [any part, except face].

Key Diagnostic Point:

A carbuncle is a painful cluster of boils that typically occurs in the skin and subcutaneous tissue, often caused by bacterial infection, particularly Staphylococcus aureus. When located on the head, excluding the face, it can present as a red, swollen area with multiple pus-filled lesions. Patients may experience systemic symptoms such as fever and malaise, indicating a more severe infection. The anatomy involved primarily includes the skin layers and underlying subcutaneous tissue, where the infection can lead to abscess formation. Disease progression can vary; if untreated, a carbuncle can lead to further complications such as cellulitis or systemic infection. Diagnostic considerations include a thorough clinical examination and, if necessary, cultures of the pus to identify the causative organism. Imaging studies are rarely required unless there is suspicion of deeper tissue involvement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes laboratory confirmation.
  • Treatment complexity: May necessitate incision and drainage, along with antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential.
  • Coding specificity: Specific to carbuncles on the head, requiring accurate anatomical coding.

Audit Risk Factors

  • Common coding errors: Misidentifying the location of the carbuncle.
  • Documentation gaps: Incomplete clinical notes regarding the extent of the infection.
  • Billing challenges: Potential denials if the 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

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 health, leading to discomfort, potential systemic infections, and increased healthcare utilization. Understanding the epidemiology of carbuncles, particularly in populations with higher rates of skin infections, is crucial for public health initiatives. Quality measures may include tracking the incidence of carbuncles and ensuring appropriate treatment protocols are followed to reduce complications.

ICD-9 vs ICD-10

Carbuncles can significantly impact patient health, leading to discomfort, potential systemic infections, and increased healthcare utilization. Understanding the epidemiology of carbuncles, particularly in populations with higher rates of skin infections, is crucial for public health initiatives. Quality measures may include tracking the incidence of carbuncles and ensuring appropriate treatment protocols are followed to reduce complications.

Reimbursement & Billing Impact

Reimbursement may be affected by the completeness of the documentation, particularly if surgical intervention is performed. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedure. Coders should ensure that all relevant details are captured to support the diagnosis and any associated procedures.

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 L02.831?

L02.831 specifically covers carbuncles located on the head, excluding the face. It is characterized by the presence of multiple interconnected boils and is often associated with bacterial infections.

When should L02.831 be used instead of related codes?

L02.831 should be used when the carbuncle is confirmed to be on the head and not on the face. Accurate anatomical localization is crucial for correct coding.

What documentation supports L02.831?

Documentation should include a detailed clinical assessment of the lesion, treatment provided, and any laboratory results if cultures were taken. Notes should clearly indicate the location of the carbuncle.