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ICD-10 Guide
ICD-10 CodesL30.4

L30.4

Billable

Erythema intertrigo

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

Code Description

ICD-10 L30.4 is a billable code used to indicate a diagnosis of erythema intertrigo.

Key Diagnostic Point:

Erythema intertrigo is a common inflammatory skin condition characterized by erythema and irritation occurring in skin folds, such as the axillae, groin, and under the breasts. The condition arises due to friction, moisture, and heat, leading to a breakdown of the skin barrier. Clinically, patients present with red, inflamed patches that may be accompanied by burning, itching, and sometimes secondary infections due to yeast or bacteria. The anatomy involved primarily includes the epidermis and dermis within the affected skin folds. Disease progression can vary; if left untreated, it may lead to more severe dermatitis or secondary infections. Diagnostic considerations include a thorough clinical examination and, if necessary, skin scrapings or cultures to rule out fungal or bacterial infections. It is essential to differentiate erythema intertrigo from other dermatological conditions such as psoriasis or contact dermatitis to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other skin conditions
  • Treatment complexity: May involve topical antifungals, corticosteroids, and lifestyle modifications
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary
  • Coding specificity: Requires accurate identification of the condition and its location

Audit Risk Factors

  • Common coding errors: Misidentification of the condition or location
  • Documentation gaps: Incomplete clinical notes or lack of follow-up information
  • Billing challenges: Potential denials due to insufficient evidence of medical necessity

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

Erythema intertrigo has significant clinical implications, particularly in populations with obesity or diabetes, where skin folds are more prevalent. The condition can lead to increased healthcare utilization due to secondary infections and complications. Quality measures may include monitoring the incidence of intertrigo in at-risk populations, and effective management can improve patient outcomes and reduce healthcare costs associated with complications.

ICD-9 vs ICD-10

Erythema intertrigo has significant clinical implications, particularly in populations with obesity or diabetes, where skin folds are more prevalent. The condition can lead to increased healthcare utilization due to secondary infections and complications. Quality measures may include monitoring the incidence of intertrigo in at-risk populations, and effective management can improve patient outcomes and reduce healthcare costs associated with complications.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of thorough clinical notes that detail the patient's symptoms, treatment plans, and any follow-up care. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the treatment provided. Best practices include using precise coding, maintaining comprehensive patient records, and ensuring that all relevant clinical information is included in the billing submission.

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 L30.4?

L30.4 specifically covers erythema intertrigo, which is characterized by inflammation in skin folds. It may also include secondary infections such as candidiasis or bacterial infections that arise from the intertrigo itself.

When should L30.4 be used instead of related codes?

L30.4 should be used when the primary diagnosis is erythema intertrigo, particularly when the condition is localized to skin folds and presents with characteristic symptoms. It should not be used for generalized skin erythema or other inflammatory skin conditions.

What documentation supports L30.4?

Documentation should include a detailed description of the affected areas, symptoms reported by the patient, any treatments attempted, and the clinical rationale for the diagnosis. Photographic evidence may also be beneficial.