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v1.0.0
ICD-10 Guide
ICD-10 CodesL01.09

L01.09

Billable

Other impetigo

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

Code Description

ICD-10 L01.09 is a billable code used to indicate a diagnosis of other impetigo.

Key Diagnostic Point:

L01.09 refers to 'Other impetigo,' a bacterial skin infection primarily caused by Staphylococcus aureus or Streptococcus pyogenes. Clinically, impetigo presents as vesicular lesions that rupture, leading to honey-colored crusts, typically on the face, arms, and legs. The condition is most common in children but can affect individuals of any age. The disease progression often begins with minor skin trauma, allowing bacteria to invade the epidermis. Diagnosis is primarily clinical, based on the characteristic appearance of the lesions, although laboratory confirmation may be necessary in atypical cases. Differential diagnoses include contact dermatitis, herpes simplex, and other vesicular diseases. Treatment typically involves topical antibiotics for localized cases and systemic antibiotics for widespread infections. Proper hygiene and wound care are essential to prevent recurrence and spread. Understanding the anatomy involved, particularly the epidermis and dermis, is crucial for effective management and prevention of complications such as cellulitis or systemic infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires clinical evaluation and sometimes laboratory confirmation.
  • Treatment complexity: Moderate, involving topical and/or systemic antibiotics.
  • Documentation requirements: Requires detailed clinical notes on presentation and treatment.
  • Coding specificity: Moderate, as it differentiates from other types of impetigo.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin conditions.
  • Documentation gaps: Incomplete clinical notes regarding lesion characteristics.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

Pediatrics

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

Impetigo, including cases classified under L01.09, has significant clinical implications, particularly in pediatric populations where it can spread rapidly in communal settings. Understanding the epidemiology of impetigo helps in implementing effective public health measures to reduce transmission. Quality measures may include monitoring treatment outcomes and adherence to guidelines for managing skin infections, which can ultimately influence healthcare utilization patterns and improve patient outcomes.

ICD-9 vs ICD-10

Impetigo, including cases classified under L01.09, has significant clinical implications, particularly in pediatric populations where it can spread rapidly in communal settings. Understanding the epidemiology of impetigo helps in implementing effective public health measures to reduce transmission. Quality measures may include monitoring treatment outcomes and adherence to guidelines for managing skin infections, which can ultimately influence healthcare utilization patterns and improve patient outcomes.

Reimbursement & Billing Impact

Impetigo, including cases classified under L01.09, has significant clinical implications, particularly in pediatric populations where it can spread rapidly in communal settings. Understanding the epidemiology of impetigo helps in implementing effective public health measures to reduce transmission. Quality measures may include monitoring treatment outcomes and adherence to guidelines for managing skin infections, which can ultimately influence healthcare utilization patterns and improve patient outcomes.

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 L01.09?

L01.09 covers cases of impetigo that do not fit the more common categories, including atypical presentations or those caused by less common pathogens. It is essential to document the specific characteristics of the lesions and any underlying conditions that may contribute to the infection.

When should L01.09 be used instead of related codes?

L01.09 should be used when the impetigo presentation is not typical or when it is caused by organisms other than those specified in related codes. Clear documentation of the clinical presentation and any diagnostic tests performed is necessary to justify the use of this code.

What documentation supports L01.09?

Documentation should include a detailed description of the lesions, their location, duration, and any associated symptoms. Clinical notes should also reflect the treatment plan and response to therapy, along with any relevant laboratory results.