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ICD-10 Guide
ICD-10 CodesL73.2

L73.2

Billable

Hidradenitis suppurativa

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

Code Description

ICD-10 L73.2 is a billable code used to indicate a diagnosis of hidradenitis suppurativa.

Key Diagnostic Point:

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent painful nodules, abscesses, and sinus tracts primarily affecting areas with apocrine glands, such as the axillae, groin, and under the breasts. The condition often begins after puberty and is more prevalent in women than men. HS can lead to significant physical discomfort and psychological distress due to its chronic nature and visibility. The disease progresses through stages, starting with painful lumps that can rupture and drain pus, leading to scarring and skin changes over time. Diagnostic considerations include a thorough clinical history and physical examination, as well as ruling out other conditions such as folliculitis or skin infections. Imaging studies may be utilized in severe cases to assess the extent of the disease. Early diagnosis and management are crucial to prevent complications and improve quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis from other skin conditions.
  • Treatment complexity: Management may involve medical, surgical, and lifestyle interventions.
  • Documentation requirements: Detailed clinical notes are essential for accurate coding.
  • Coding specificity: Requires precise coding to capture the severity and location of lesions.

Audit Risk Factors

  • Common coding errors: Misclassification of HS as other skin conditions.
  • Documentation gaps: Incomplete records regarding the severity and treatment history.
  • Billing challenges: Potential for denials if documentation does not support the chronicity or severity 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

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

Hidradenitis suppurativa significantly impacts the quality of life for affected individuals, leading to physical discomfort and psychological distress. It is estimated to affect 1-4% of the population, with higher prevalence in individuals with obesity and metabolic syndrome. Understanding HS's epidemiology is crucial for healthcare providers to implement effective management strategies and improve patient outcomes. Quality measures may include tracking treatment efficacy and patient-reported outcomes to enhance care delivery.

ICD-9 vs ICD-10

Hidradenitis suppurativa significantly impacts the quality of life for affected individuals, leading to physical discomfort and psychological distress. It is estimated to affect 1-4% of the population, with higher prevalence in individuals with obesity and metabolic syndrome. Understanding HS's epidemiology is crucial for healthcare providers to implement effective management strategies and improve patient outcomes. Quality measures may include tracking treatment efficacy and patient-reported outcomes to enhance care delivery.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of care, which may involve multiple visits for management and potential surgical interventions. Common denials can occur if the documentation does not clearly support the diagnosis or if the treatment plan is not well articulated. Best practices include maintaining thorough clinical notes, ensuring that all services rendered are documented, and using appropriate modifiers when necessary to indicate the nature of the treatment provided.

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 L73.2?

L73.2 specifically covers hidradenitis suppurativa, which may present with recurrent abscesses, nodules, and scarring in areas with apocrine glands. It is important to differentiate HS from other skin conditions such as acne or folliculitis.

When should L73.2 be used instead of related codes?

L73.2 should be used when the patient presents with classic symptoms of hidradenitis suppurativa, particularly when there is a history of recurrent lesions and significant scarring. It is essential to document the chronicity and severity to justify the use of this specific code.

What documentation supports L73.2?

Documentation should include a detailed history of the patient's symptoms, physical examination findings, treatment history, and any imaging studies if performed. Notes should clearly indicate the recurrent nature of the lesions and any associated complications.