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ICD-10 Guide
ICD-10 CodesL74.511

L74.511

Billable

Primary focal hyperhidrosis, face

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

Code Description

ICD-10 L74.511 is a billable code used to indicate a diagnosis of primary focal hyperhidrosis, face.

Key Diagnostic Point:

Primary focal hyperhidrosis of the face is a condition characterized by excessive sweating localized to the facial region, often triggered by emotional stimuli, heat, or physical exertion. The condition primarily affects the sweat glands in the face, leading to significant discomfort and social anxiety for patients. The pathophysiology involves overactivity of the sympathetic nervous system, which stimulates eccrine sweat glands. Clinically, patients may present with visible sweating, skin irritation, and potential secondary skin infections due to moisture retention. Disease progression can vary; while some patients may experience symptoms intermittently, others may have persistent hyperhidrosis. Diagnostic considerations include a thorough patient history, physical examination, and potentially the use of the Minor's test to assess sweat production. It is essential to differentiate primary hyperhidrosis from secondary causes, such as endocrine disorders or medication side effects, to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from secondary causes of hyperhidrosis.
  • Treatment complexity: Options include topical agents, iontophoresis, botulinum toxin injections, and surgical interventions.
  • Documentation requirements: Detailed patient history and symptomatology must be documented.
  • Coding specificity: Requires accurate coding to reflect the specific site of hyperhidrosis.

Audit Risk Factors

  • Common coding errors: Misclassification of primary vs. secondary hyperhidrosis.
  • Documentation gaps: Incomplete patient history or lack of symptom severity assessment.
  • Billing challenges: Potential denials due to insufficient evidence of medical necessity for treatment.

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

Psychiatry

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

Primary focal hyperhidrosis, particularly of the face, can significantly affect a patient's quality of life, leading to social anxiety and decreased productivity. The condition is prevalent, with estimates suggesting it affects 1-3% of the population. Understanding its impact on mental health and social interactions is crucial for healthcare providers. Effective management can improve patient outcomes and reduce healthcare utilization related to secondary complications, such as skin infections or psychological distress.

ICD-9 vs ICD-10

Primary focal hyperhidrosis, particularly of the face, can significantly affect a patient's quality of life, leading to social anxiety and decreased productivity. The condition is prevalent, with estimates suggesting it affects 1-3% of the population. Understanding its impact on mental health and social interactions is crucial for healthcare providers. Effective management can improve patient outcomes and reduce healthcare utilization related to secondary complications, such as skin infections or psychological distress.

Reimbursement & Billing Impact

impact of hyperhidrosis on the patient's daily life. Additionally, understanding payer-specific guidelines for reimbursement is essential to avoid billing issues.

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 L74.511?

L74.511 specifically covers primary focal hyperhidrosis localized to the face. It does not include secondary hyperhidrosis caused by other medical conditions or medications.

When should L74.511 be used instead of related codes?

L74.511 should be used when the hyperhidrosis is primary and localized to the face, distinguishing it from other body areas or secondary causes of excessive sweating.

What documentation supports L74.511?

Documentation should include a detailed patient history, symptom severity, duration of symptoms, and any previous treatments attempted. Clinical notes should reflect the impact of the condition on the patient's quality of life.