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v1.0.0
ICD-10 Guide
ICD-10 CodesL28.0

L28.0

Billable

Lichen simplex chronicus

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

Code Description

ICD-10 L28.0 is a billable code used to indicate a diagnosis of lichen simplex chronicus.

Key Diagnostic Point:

Lichen simplex chronicus is a skin condition characterized by thickened, leathery patches of skin resulting from chronic scratching or rubbing. It commonly occurs in areas prone to friction, such as the neck, scalp, and extremities. The condition is often associated with underlying dermatological issues like eczema or psoriasis, but it can also arise independently due to stress or anxiety. Clinically, patients present with pruritus (itching), which leads to a cycle of scratching and further skin irritation. The affected skin may appear hyperpigmented, and the texture is typically rough and thickened. Diagnosis is primarily clinical, based on the characteristic appearance and history of itching and scratching. A skin biopsy may be performed to rule out other conditions. Disease progression can lead to significant discomfort and secondary infections if not managed appropriately. Treatment focuses on breaking the itch-scratch cycle, often involving topical corticosteroids, antihistamines, and behavioral modifications to reduce scratching.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other dermatological conditions.
  • Treatment complexity: Involves multiple treatment modalities and patient education.
  • Documentation requirements: Detailed history of symptoms and treatment response needed.
  • Coding specificity: Requires accurate coding to reflect the chronic nature of the condition.

Audit Risk Factors

  • Common coding errors: Misclassification with other dermatitis codes.
  • Documentation gaps: Incomplete patient history or treatment notes.
  • Billing challenges: Denials due to lack of supporting documentation for chronicity.

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

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Lichen simplex chronicus can significantly impact a patient's quality of life due to persistent itching and discomfort. It is essential to address this condition not only for individual patient care but also for broader population health, as it may lead to increased healthcare utilization due to secondary infections or complications. Understanding the epidemiology of this condition can help healthcare providers implement effective management strategies and improve quality measures related to skin disorders.

ICD-9 vs ICD-10

Lichen simplex chronicus can significantly impact a patient's quality of life due to persistent itching and discomfort. It is essential to address this condition not only for individual patient care but also for broader population health, as it may lead to increased healthcare utilization due to secondary infections or complications. Understanding the epidemiology of this condition can help healthcare providers implement effective management strategies and improve quality measures related to skin disorders.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, but it is essential to provide clear evidence of the chronic nature of the condition to avoid denials. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include maintaining thorough records of patient interactions and treatment plans, ensuring that all relevant information is included in claims submissions.

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 L28.0?

L28.0 specifically covers lichen simplex chronicus, which may occur as a result of other skin conditions like eczema or psoriasis but is characterized by its own distinct presentation of thickened, itchy skin.

When should L28.0 be used instead of related codes?

L28.0 should be used when the primary issue is chronic itching and scratching leading to skin thickening, differentiating it from other dermatitis codes that may not involve the same chronic behavior.

What documentation supports L28.0?

Documentation should include a detailed patient history of itching and scratching, clinical examination findings, and any previous treatments attempted, as well as responses to those treatments.