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v1.0.0
ICD-10 Guide
ICD-10 CodesL72.0

L72.0

Billable

Epidermal cyst

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

Code Description

ICD-10 L72.0 is a billable code used to indicate a diagnosis of epidermal cyst.

Key Diagnostic Point:

Epidermal cysts, also known as epidermoid cysts, are benign, closed sacs filled with keratin that form within the epidermis or the upper layer of the dermis. These cysts are commonly found on the face, neck, and trunk, but can occur anywhere on the body. Clinically, they present as small, round, firm nodules that may be skin-colored or slightly yellowish. While they are generally asymptomatic, they can become inflamed or infected, leading to pain and discomfort. The cysts arise from hair follicles or skin glands, and their contents can vary in consistency. Disease progression is typically slow, and they may remain stable for years. Diagnosis is primarily clinical, based on physical examination, but imaging studies may be employed in atypical cases to rule out other conditions. Differential diagnoses include lipomas, sebaceous cysts, and other skin lesions. Accurate diagnosis is crucial to avoid unnecessary surgical interventions.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Diagnostic complexity: Low - diagnosis is usually straightforward based on clinical presentation.
  • Treatment complexity: Low - treatment often involves simple excision if symptomatic.
  • Documentation requirements: Low - standard documentation of clinical findings is sufficient.
  • Coding specificity: Medium - while L72.0 is specific, related codes exist for other types of cysts.

Audit Risk Factors

  • Common coding errors: Misidentification of cyst type, leading to incorrect coding.
  • Documentation gaps: Incomplete clinical notes regarding the cyst's characteristics.
  • Billing challenges: Potential denials if the cyst is not documented as symptomatic.

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

General Surgery

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

Epidermal cysts are common dermatological conditions that can affect individuals of all ages. While generally benign, they can lead to complications such as infection or cosmetic concerns, prompting healthcare utilization for treatment. Understanding the epidemiology of epidermal cysts can help healthcare providers identify at-risk populations and improve management strategies. Quality measures may include tracking the incidence of complications related to cysts and ensuring appropriate follow-up care.

ICD-9 vs ICD-10

Epidermal cysts are common dermatological conditions that can affect individuals of all ages. While generally benign, they can lead to complications such as infection or cosmetic concerns, prompting healthcare utilization for treatment. Understanding the epidemiology of epidermal cysts can help healthcare providers identify at-risk populations and improve management strategies. Quality measures may include tracking the incidence of complications related to cysts and ensuring appropriate follow-up care.

Reimbursement & Billing Impact

Epidermal cysts are common dermatological conditions that can affect individuals of all ages. While generally benign, they can lead to complications such as infection or cosmetic concerns, prompting healthcare utilization for treatment. Understanding the epidemiology of epidermal cysts can help healthcare providers identify at-risk populations and improve management strategies. Quality measures may include tracking the incidence of complications related to cysts and ensuring appropriate follow-up care.

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 L72.0?

L72.0 specifically covers epidermal cysts, which are benign cystic lesions filled with keratin. It does not include other types of cysts such as pilar cysts or steatocystomas, which have their own specific codes.

When should L72.0 be used instead of related codes?

L72.0 should be used when the clinical presentation clearly indicates an epidermal cyst. If the cyst is sebaceous or of another type, the appropriate related code should be selected based on the specific characteristics and location of the cyst.

What documentation supports L72.0?

Documentation should include a detailed description of the cyst's size, location, and any symptoms such as pain or inflammation. Photographic evidence may also support the diagnosis, along with notes on any previous treatments or interventions.