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ICD-10 Guide
ICD-10 CodesL02.91

L02.91

Billable

Cutaneous abscess, unspecified

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

Code Description

ICD-10 L02.91 is a billable code used to indicate a diagnosis of cutaneous abscess, unspecified.

Key Diagnostic Point:

L02.91 refers to a cutaneous abscess that is unspecified, indicating a localized collection of pus within the skin or subcutaneous tissue. These abscesses typically arise from bacterial infections, often due to Staphylococcus aureus, and can occur in various anatomical locations, including the face, neck, axilla, and groin. Clinically, patients may present with symptoms such as localized swelling, redness, warmth, and tenderness, often accompanied by systemic signs of infection like fever. The progression of a cutaneous abscess can vary; if left untreated, it may lead to further complications such as cellulitis or systemic infection. Diagnosis is primarily clinical, supported by physical examination findings, and may be confirmed through imaging studies or aspiration of the abscess for culture. Treatment typically involves incision and drainage, along with antibiotic therapy when indicated. It is crucial for healthcare providers to differentiate between abscesses and other skin lesions, as this affects management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical evaluation and sometimes imaging.
  • Treatment complexity: Moderate, involving procedural intervention and potential antibiotic therapy.
  • Documentation requirements: Requires detailed documentation of symptoms, treatment, and follow-up.
  • Coding specificity: Moderate, as it is important to specify the location and nature of the abscess.

Audit Risk Factors

  • Common coding errors: Misclassification of abscess type or location.
  • Documentation gaps: Incomplete records of symptoms or treatment.
  • 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: 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 L02.91 lies in its association with skin infections, which can affect a large segment of the population. Proper coding and management of cutaneous abscesses can lead to improved patient outcomes, reduced healthcare utilization, and lower rates of complications. Epidemiologically, understanding the prevalence and treatment of abscesses can inform public health strategies aimed at reducing skin infection rates and improving overall skin health.

ICD-9 vs ICD-10

The clinical significance of L02.91 lies in its association with skin infections, which can affect a large segment of the population. Proper coding and management of cutaneous abscesses can lead to improved patient outcomes, reduced healthcare utilization, and lower rates of complications. Epidemiologically, understanding the prevalence and treatment of abscesses can inform public health strategies aimed at reducing skin infection rates and improving overall skin health.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure, the setting in which care is provided, and any associated costs for laboratory tests. Common denials may arise from insufficient documentation or lack of medical necessity, emphasizing the importance of thorough record-keeping and adherence to coding guidelines.

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 L02.91?

L02.91 covers unspecified cutaneous abscesses that may arise from various causes, including bacterial infections, foreign bodies, or underlying skin conditions. It does not specify the location or etiology, allowing for broad application in clinical settings.

When should L02.91 be used instead of related codes?

L02.91 should be used when the abscess is not further specified by location or type. If the abscess can be classified more specifically (e.g., L02.90 for unspecified site), those codes should be used to enhance coding accuracy.

What documentation supports L02.91?

Documentation should include a detailed description of the abscess, including location, size, symptoms, treatment performed (e.g., incision and drainage), and any laboratory results from cultures if obtained.