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ICD-10 Guide
ICD-10 CodesL72.3

L72.3

Billable

Sebaceous cyst

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

Code Description

ICD-10 L72.3 is a billable code used to indicate a diagnosis of sebaceous cyst.

Key Diagnostic Point:

Sebaceous cysts, also known as epidermoid cysts, are benign, closed sacs under the skin filled with a thick, oily substance called sebum. They commonly occur on the face, neck, and trunk but can develop anywhere on the body. Clinically, sebaceous cysts present as small, round, mobile lumps that may be skin-colored or slightly yellowish. They are typically asymptomatic but can become inflamed or infected, leading to pain and discomfort. The cysts arise from the sebaceous glands or hair follicles, where the normal drainage of sebum is obstructed, causing accumulation. Disease progression is generally slow, and while they are not harmful, they may require surgical intervention if they become bothersome or infected. Diagnostic considerations include a physical examination and, in some cases, imaging studies to differentiate them from other skin lesions. A biopsy may be performed if malignancy is suspected.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Diagnostic complexity: Low, as sebaceous cysts are easily identifiable through physical examination.
  • Treatment complexity: Low, typically requiring simple excision if treatment is necessary.
  • Documentation requirements: Moderate, requiring clear descriptions of the cyst's characteristics and any treatment performed.
  • Coding specificity: Moderate, as L72.3 specifically identifies sebaceous cysts but may require additional codes for complications.

Audit Risk Factors

  • Common coding errors: Misidentification of cyst type or confusion with other skin lesions.
  • Documentation gaps: Incomplete records regarding the cyst's characteristics or treatment details.
  • Billing challenges: Potential denials if the necessity for treatment is not well-documented.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Sebaceous cysts are common dermatological conditions that can affect a significant portion of the population, often leading to increased healthcare utilization when complications arise. Their benign nature typically results in low morbidity; however, when inflamed or infected, they can lead to secondary infections requiring additional medical attention. Understanding the epidemiology of sebaceous cysts can aid in developing quality measures aimed at improving patient outcomes and reducing unnecessary procedures.

ICD-9 vs ICD-10

Sebaceous cysts are common dermatological conditions that can affect a significant portion of the population, often leading to increased healthcare utilization when complications arise. Their benign nature typically results in low morbidity; however, when inflamed or infected, they can lead to secondary infections requiring additional medical attention. Understanding the epidemiology of sebaceous cysts can aid in developing quality measures aimed at improving patient outcomes and reducing unnecessary procedures.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the procedure performed, such as excision versus simple drainage. Common denials may arise from insufficient documentation of the medical necessity for the procedure. Coders should ensure that all relevant details are included in the medical record to support the billed services and avoid potential audits.

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 L72.3?

L72.3 specifically covers sebaceous cysts, which are benign cystic lesions filled with sebum. It does not include other types of cysts such as pilar cysts or those associated with inflammatory conditions.

When should L72.3 be used instead of related codes?

L72.3 should be used when the diagnosis is confirmed as a sebaceous cyst. If the cyst is inflamed or infected, additional codes may be necessary to capture the complication.

What documentation supports L72.3?

Documentation should include a detailed description of the cyst's size, location, and characteristics, as well as any symptoms experienced by the patient. Surgical notes should detail the procedure if excision is performed.