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ICD-10 Guide
ICD-10 CodesL02.1

L02.1

Non-billable

Cutaneous abscess, furuncle and carbuncle of neck

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

Code Description

ICD-10 L02.1 is a used to indicate a diagnosis of cutaneous abscess, furuncle and carbuncle of neck.

Key Diagnostic Point:

L02.1 refers to cutaneous abscesses, furuncles, and carbuncles located on the neck. These conditions are characterized by localized collections of pus within the skin or subcutaneous tissue, often resulting from bacterial infections, most commonly Staphylococcus aureus. Clinically, patients may present with painful, swollen areas that are red and warm to the touch. Furuncles, commonly known as boils, are single, painful nodules, while carbuncles are larger, more severe infections that involve multiple hair follicles and can lead to systemic symptoms such as fever. The neck's anatomy, with its rich vascular supply and numerous hair follicles, makes it susceptible to these infections. Disease progression can lead to complications such as cellulitis or systemic infection if not adequately treated. Diagnostic considerations include physical examination and, in some cases, culture of the pus to identify the causative organism. Treatment typically involves incision and drainage, along with antibiotics if indicated, particularly in cases of recurrent infections or systemic involvement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes laboratory confirmation.
  • Treatment complexity: May involve surgical intervention and antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary.
  • Coding specificity: Requires accurate identification of the location and type of abscess.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of abscess or incorrect anatomical location.
  • Documentation gaps: Incomplete clinical notes regarding the extent of the infection or treatment provided.
  • Billing challenges: Potential denials if documentation does not support the severity or necessity of the procedure.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: 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

The clinical significance of L02.1 lies in its potential to lead to more severe infections if not treated promptly. Population health impact includes the burden of skin infections, which can affect quality of life and lead to increased healthcare utilization. Quality measures may focus on timely treatment and prevention of complications, while epidemiological considerations highlight the prevalence of skin infections in various demographics, particularly in settings with limited access to healthcare.

ICD-9 vs ICD-10

The clinical significance of L02.1 lies in its potential to lead to more severe infections if not treated promptly. Population health impact includes the burden of skin infections, which can affect quality of life and lead to increased healthcare utilization. Quality measures may focus on timely treatment and prevention of complications, while epidemiological considerations highlight the prevalence of skin infections in various demographics, particularly in settings with limited access to healthcare.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure, the necessity of antibiotics, and follow-up care. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for surgical intervention. Best practices include ensuring that all clinical notes are complete and that the rationale for treatment is clearly articulated in the patient's medical record.

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 L02.1?

L02.1 covers cutaneous abscesses, furuncles, and carbuncles specifically located on the neck. These conditions are characterized by localized infections that can cause pain, swelling, and redness, often requiring drainage and sometimes antibiotic treatment.

When should L02.1 be used instead of related codes?

L02.1 should be used when the abscess, furuncle, or carbuncle is specifically located on the neck. It is important to differentiate this from abscesses located on other body parts, as the treatment and potential complications may vary.

What documentation supports L02.1?

Documentation should include a thorough clinical examination, details of the lesion's characteristics, treatment provided (such as incision and drainage), and any laboratory results if cultures were taken. Clear notes on the patient's symptoms and response to treatment are also essential.