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v1.0.0
ICD-10 Guide
ICD-10 CodesL02.9

L02.9

Non-billable

Cutaneous abscess, furuncle and carbuncle, unspecified

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

Code Description

ICD-10 L02.9 is a used to indicate a diagnosis of cutaneous abscess, furuncle and carbuncle, unspecified.

Key Diagnostic Point:

L02.9 refers to a cutaneous abscess, furuncle, and carbuncle that is unspecified. These conditions are characterized by localized collections of pus within the skin or subcutaneous tissue, often resulting from bacterial infections, most commonly Staphylococcus aureus. Clinically, patients may present with painful, swollen areas on the skin that are red and warm to the touch. The abscess may fluctuate, indicating the presence of pus, and can occur anywhere on the body. The disease progression typically involves the formation of a tender lump, which may eventually rupture and drain spontaneously or require surgical intervention. Diagnostic considerations include a thorough history and physical examination, and in some cases, imaging studies may be warranted to assess the extent of the infection. Laboratory tests, such as cultures, may be performed to identify the causative organism, especially in recurrent cases. It is crucial to differentiate L02.9 from other skin conditions such as cellulitis or infected cysts to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes laboratory tests to confirm the diagnosis.
  • Treatment complexity: May involve simple drainage or more complex surgical procedures depending on the size and location of the abscess.
  • Documentation requirements: Requires detailed documentation of the clinical presentation, treatment provided, and follow-up care.
  • Coding specificity: While L02.9 is a general code, more specific codes exist for particular types of abscesses, which may complicate coding.

Audit Risk Factors

  • Common coding errors: Misclassification of abscess types or failure to document the site of the abscess.
  • Documentation gaps: Incomplete records regarding the size, location, and treatment of the abscess.
  • Billing challenges: Potential for denials if the documentation does not support the diagnosis or if the procedure performed is not adequately justified.

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: General Surgery

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 L02.9 lies in its association with bacterial infections that can lead to complications if left untreated. Population health impact includes the potential for increased healthcare utilization due to recurrent infections or complications such as cellulitis. Quality measures may focus on timely interventions and appropriate management of skin infections, while epidemiological considerations highlight the importance of understanding the prevalence of skin infections in various populations.

ICD-9 vs ICD-10

The clinical significance of L02.9 lies in its association with bacterial infections that can lead to complications if left untreated. Population health impact includes the potential for increased healthcare utilization due to recurrent infections or complications such as cellulitis. Quality measures may focus on timely interventions and appropriate management of skin infections, while epidemiological considerations highlight the importance of understanding the prevalence of skin infections in various populations.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure and the necessity for surgical intervention. Common denials may arise from insufficient documentation or failure to provide adequate justification for the services rendered. Best practices include maintaining thorough clinical notes, ensuring accurate coding based on the specifics of the case, and following up on any claims that are denied to address potential issues promptly.

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 L02.9?

L02.9 encompasses unspecified cutaneous abscesses, furuncles, and carbuncles. It is used when the specific site or type of abscess is not documented, but the presence of a localized infection is confirmed.

When should L02.9 be used instead of related codes?

L02.9 should be used when the specific type of abscess or its location is not clearly defined in the medical record. If the documentation specifies the site or type, more specific codes should be utilized.

What documentation supports L02.9?

Documentation should include a detailed description of the lesion, including size, location, symptoms, treatment provided, and any follow-up care. Clinical notes should clearly indicate the diagnosis of a cutaneous abscess.