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ICD-10 Guide
ICD-10 CodesL02.838

L02.838

Billable

Carbuncle of other sites

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

Code Description

ICD-10 L02.838 is a billable code used to indicate a diagnosis of carbuncle of other sites.

Key Diagnostic Point:

L02.838 refers to a carbuncle located on sites other than the commonly affected areas such as the neck, back, or thighs. 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. Clinically, carbuncles present as red, swollen lumps that may drain pus and are often accompanied by systemic symptoms such as fever and malaise. The anatomy involved includes the skin and subcutaneous tissue, where the infection leads to inflammation and necrosis of hair follicles and surrounding tissues. Disease progression can vary; if untreated, carbuncles may lead to complications such as abscess formation or systemic infection. Diagnostic considerations include a thorough clinical examination, history of recurrent skin infections, and, in some cases, laboratory tests to identify the causative organism. Differential diagnoses may include other skin infections like abscesses, folliculitis, or hidradenitis suppurativa.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

The clinical significance of L02.838 lies in its potential to lead to serious complications if not treated promptly. Carbuncles can affect a significant portion of the population, particularly those with compromised immune systems or poor hygiene. Understanding the epidemiology of skin infections like carbuncles can help healthcare providers implement effective prevention strategies and improve patient outcomes.

ICD-9 vs ICD-10

The clinical significance of L02.838 lies in its potential to lead to serious complications if not treated promptly. Carbuncles can affect a significant portion of the population, particularly those with compromised immune systems or poor hygiene. Understanding the epidemiology of skin infections like carbuncles can help healthcare providers implement effective prevention strategies and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and the necessity for follow-up care. Common denials may arise from insufficient documentation or failure to establish medical necessity. Coders should ensure that all relevant details are captured in the medical record 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 L02.838?

L02.838 covers carbuncles located on sites other than the neck, trunk, or limbs. It includes conditions where multiple interconnected furuncles occur, leading to a more extensive infection that may require surgical intervention.

When should L02.838 be used instead of related codes?

L02.838 should be used when the carbuncle is not located on the neck, trunk, or limbs, and when the clinical presentation aligns with the definition of a carbuncle rather than other skin infections.

What documentation supports L02.838?

Documentation should include a detailed clinical examination, notes on the location and characteristics of the carbuncle, any systemic symptoms, and treatment plans. Laboratory results confirming the bacterial infection may also be beneficial.