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ICD-10 Guide
ICD-10 CodesL30.5

L30.5

Billable

Pityriasis alba

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

Code Description

ICD-10 L30.5 is a billable code used to indicate a diagnosis of pityriasis alba.

Key Diagnostic Point:

Pityriasis alba is a common, benign skin condition characterized by the presence of hypopigmented patches on the skin, primarily affecting children and adolescents. Clinically, it presents as light-colored, scaly patches that are often found on the face, arms, and upper body. The lesions are typically asymptomatic, though they may occasionally be slightly itchy. The condition is thought to be related to a history of atopic dermatitis, and it is more prevalent in individuals with darker skin tones due to the contrast between the affected areas and the surrounding skin. The pathophysiology involves a reduction in melanin production in the affected areas, and while the exact cause remains unclear, it may be associated with environmental factors, sun exposure, and skin dryness. Diagnosis is primarily clinical, based on the characteristic appearance of the lesions, and may be supported by a history of atopic dermatitis. Differential diagnoses include vitiligo, tinea versicolor, and other hypopigmented skin disorders. Treatment is usually not required, but emollients and topical corticosteroids may be used to alleviate any associated dryness or irritation.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Diagnostic complexity: Low - primarily clinical diagnosis
  • Treatment complexity: Low - often self-limiting
  • Documentation requirements: Moderate - requires clear clinical notes
  • Coding specificity: Low - specific to pityriasis alba

Audit Risk Factors

  • Common coding errors: Misidentification with other skin conditions
  • Documentation gaps: Lack of detailed clinical notes
  • Billing challenges: Limited reimbursement due to the benign nature of the condition

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

Pediatrics

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

Pityriasis alba, while benign, can have a significant impact on the quality of life for affected individuals, particularly adolescents who may be self-conscious about their appearance. Understanding its prevalence and management is crucial for healthcare providers, as it can influence patient interactions and treatment approaches. Epidemiologically, it is more common in populations with darker skin, highlighting the need for culturally competent care in dermatological practices.

ICD-9 vs ICD-10

Pityriasis alba, while benign, can have a significant impact on the quality of life for affected individuals, particularly adolescents who may be self-conscious about their appearance. Understanding its prevalence and management is crucial for healthcare providers, as it can influence patient interactions and treatment approaches. Epidemiologically, it is more common in populations with darker skin, highlighting the need for culturally competent care in dermatological practices.

Reimbursement & Billing Impact

reimbursement may be limited, and providers should ensure that documentation clearly outlines the clinical necessity of any interventions. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include thorough patient history, clear descriptions of the lesions, and any treatments attempted, even if they are conservative.

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 L30.5?

L30.5 specifically covers pityriasis alba, which is characterized by hypopigmented patches on the skin, primarily in children and adolescents. It is important to differentiate it from other skin conditions such as vitiligo and tinea versicolor.

When should L30.5 be used instead of related codes?

L30.5 should be used when the clinical presentation aligns with pityriasis alba, particularly when there is a history of atopic dermatitis and the lesions are asymptomatic. It should not be used for conditions that present with more pronounced symptoms or different lesion characteristics.

What documentation supports L30.5?

Documentation should include a detailed clinical examination noting the appearance of the lesions, patient history including any atopic dermatitis, and any treatments attempted. Photographic evidence may also be beneficial.