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ICD-10 Guide
ICD-10 CodesL11.0

L11.0

Billable

Acquired keratosis follicularis

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

Code Description

ICD-10 L11.0 is a billable code used to indicate a diagnosis of acquired keratosis follicularis.

Key Diagnostic Point:

Acquired keratosis follicularis, also known as keratosis pilaris, is a benign skin condition characterized by the presence of small, rough, keratinized bumps primarily located on the upper arms, thighs, cheeks, and buttocks. It occurs due to the accumulation of keratin, a protein that protects the skin, within hair follicles, leading to obstruction and inflammation. Clinically, patients may present with asymptomatic, flesh-colored or red papules that can become more pronounced in dry conditions or during winter months. The condition is often associated with atopic dermatitis and tends to improve with age. Diagnosis is primarily clinical, based on the characteristic appearance of the lesions, and may be supported by a skin biopsy in atypical cases. Differential diagnoses include folliculitis, acne vulgaris, and other keratotic disorders. Treatment options are generally conservative, focusing on moisturizing creams, exfoliants, and topical retinoids to improve skin texture and appearance.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate; primarily clinical diagnosis but may require differentiation from other skin conditions.
  • Treatment complexity: Low; treatment is generally straightforward but may require patient education on skin care.
  • Documentation requirements: Medium; requires clear documentation of clinical findings and treatment plans.
  • Coding specificity: Medium; while the code is specific, it requires understanding of related conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with other keratotic disorders.
  • Documentation gaps: Incomplete patient history or lack of follow-up notes.
  • Billing challenges: Potential denials if documentation does not clearly 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

Primary Care

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

Acquired keratosis follicularis is a common dermatological condition that affects a significant portion of the population, particularly adolescents and young adults. Its clinical significance lies in its benign nature, but it can impact patient quality of life due to cosmetic concerns. Understanding this condition can lead to better management strategies and improved patient satisfaction. Awareness of its prevalence can also inform public health initiatives aimed at educating patients about skin health.

ICD-9 vs ICD-10

Acquired keratosis follicularis is a common dermatological condition that affects a significant portion of the population, particularly adolescents and young adults. Its clinical significance lies in its benign nature, but it can impact patient quality of life due to cosmetic concerns. Understanding this condition can lead to better management strategies and improved patient satisfaction. Awareness of its prevalence can also inform public health initiatives aimed at educating patients about skin health.

Reimbursement & Billing Impact

Reimbursement may vary based on the payer, and it is crucial to check for specific coverage policies. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for treatments. Best practices include providing clear clinical notes and ensuring that any procedures performed are justified by the diagnosis.

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 L11.0?

L11.0 specifically covers acquired keratosis follicularis, which is characterized by small, rough bumps on the skin due to keratin buildup. It is important to differentiate it from other conditions like keratosis pilaris rubra and folliculitis.

When should L11.0 be used instead of related codes?

L11.0 should be used when the clinical presentation aligns with acquired keratosis follicularis, particularly when lesions are asymptomatic and primarily located on the upper arms and thighs. Use related codes when the presentation includes additional symptoms or different locations.

What documentation supports L11.0?

Documentation should include a detailed description of the lesions, patient history, any associated symptoms, and treatment plans. Photographic evidence may also be beneficial in supporting the diagnosis.