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v1.0.0
ICD-10 Guide
ICD-10 CodesL70.0

L70.0

Billable

Acne vulgaris

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

Code Description

ICD-10 L70.0 is a billable code used to indicate a diagnosis of acne vulgaris.

Key Diagnostic Point:

Acne vulgaris is a common dermatological condition characterized by the presence of comedones, papules, pustules, and, in severe cases, cysts. It primarily affects the sebaceous glands, which are abundant in areas such as the face, back, and shoulders. The condition arises due to a combination of factors including increased sebum production, follicular hyperkeratinization, bacterial colonization (particularly by Cutibacterium acnes), and inflammation. Acne vulgaris typically presents during adolescence but can persist into adulthood. The disease can vary in severity, with mild cases involving occasional pimples and severe cases leading to significant scarring and psychological distress. Diagnosis is primarily clinical, based on the appearance of lesions and patient history. Differential diagnoses may include rosacea, folliculitis, and other skin disorders. Treatment options range from topical agents (like benzoyl peroxide and retinoids) to systemic medications (such as antibiotics and hormonal therapies), depending on the severity and response to initial treatments.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate due to the need for differential diagnosis.
  • Treatment complexity: Varies based on severity and may require multi-modal approaches.
  • Documentation requirements: Requires detailed documentation of clinical findings and treatment plans.
  • Coding specificity: Moderate; while L70.0 is specific, related codes exist for different severities and types.

Audit Risk Factors

  • Common coding errors: Misclassification of acne severity or type.
  • Documentation gaps: Incomplete patient history or treatment records.
  • Billing challenges: Denials due to lack of supporting documentation for treatment efficacy.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Acne vulgaris significantly impacts population health, affecting not only physical appearance but also psychological well-being, particularly among adolescents. It is one of the most prevalent skin disorders, influencing healthcare utilization patterns as patients seek dermatological care. Quality measures related to acne treatment focus on timely intervention and effective management strategies to reduce scarring and improve patient quality of life. Epidemiologically, acne affects a large segment of the population, with varying prevalence across different demographics.

ICD-9 vs ICD-10

Acne vulgaris significantly impacts population health, affecting not only physical appearance but also psychological well-being, particularly among adolescents. It is one of the most prevalent skin disorders, influencing healthcare utilization patterns as patients seek dermatological care. Quality measures related to acne treatment focus on timely intervention and effective management strategies to reduce scarring and improve patient quality of life. Epidemiologically, acne affects a large segment of the population, with varying prevalence across different demographics.

Reimbursement & Billing Impact

Reimbursement may vary based on the severity of the condition and the complexity of the treatment provided. Common denials can occur if documentation does not clearly support the medical necessity of the services rendered. It is essential to ensure that all services are coded accurately and that the medical record reflects the patient's clinical status and treatment rationale. Regular audits and updates to coding practices can help mitigate billing challenges.

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 L70.0?

L70.0 specifically covers acne vulgaris, which includes various forms of acne such as comedonal acne, papular acne, and pustular acne. It does not include other forms of acne such as acne conglobata or acne rosacea.

When should L70.0 be used instead of related codes?

L70.0 should be used when the condition is specifically diagnosed as acne vulgaris without further specification. If the acne is severe or has specific characteristics, related codes like L70.1 or L70.9 may be more appropriate.

What documentation supports L70.0?

Documentation should include a thorough clinical examination, patient history, treatment plans, and responses to therapies. Photographic evidence may also support the severity and progression of the condition.