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ICD-10 Guide
ICD-10 CodesL02.13

L02.13

Billable

Carbuncle of neck

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

Code Description

ICD-10 L02.13 is a billable code used to indicate a diagnosis of carbuncle of neck.

Key Diagnostic Point:

A carbuncle of the neck is a painful cluster of boils that form a connected area of infection under the skin, primarily caused by Staphylococcus aureus bacteria. Clinically, it presents as a red, swollen area that may contain pus and is often tender to the touch. The neck's anatomy, with its rich vascular supply and lymphatic drainage, can facilitate the spread of infection if not treated promptly. Disease progression may lead to systemic symptoms such as fever and malaise, especially if the infection spreads. Diagnostic considerations include a thorough clinical examination and, if necessary, cultures of the pus to identify the causative organism. Imaging studies are rarely needed unless there is suspicion of deeper tissue involvement or abscess formation. Prompt diagnosis and treatment are crucial to prevent complications such as cellulitis or sepsis, making awareness of this condition vital for healthcare providers.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly laboratory tests.
  • Treatment complexity: May involve incision and drainage, antibiotics, and follow-up care.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential.
  • Coding specificity: Requires accurate coding to differentiate from other skin infections.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin infections.
  • Documentation gaps: Incomplete clinical notes regarding the extent of infection.
  • Billing challenges: Potential denials if documentation does not support the 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

Infectious Disease

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

Carbuncles, while localized infections, can have significant clinical implications if not treated effectively. They can lead to increased healthcare utilization due to complications such as cellulitis or systemic infections. Understanding the epidemiology of carbuncles, particularly in populations with risk factors like diabetes or immunocompromised states, is crucial for preventive measures and quality care. Monitoring these infections contributes to broader public health initiatives aimed at reducing skin and soft tissue infections.

ICD-9 vs ICD-10

Carbuncles, while localized infections, can have significant clinical implications if not treated effectively. They can lead to increased healthcare utilization due to complications such as cellulitis or systemic infections. Understanding the epidemiology of carbuncles, particularly in populations with risk factors like diabetes or immunocompromised states, is crucial for preventive measures and quality care. Monitoring these infections contributes to broader public health initiatives aimed at reducing skin and soft tissue infections.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and the necessity of antibiotics. Common denials may arise if the documentation does not clearly support the diagnosis or if the procedure is deemed unnecessary. Best practices include ensuring that all clinical notes are complete and that the rationale for treatment is well-documented to support the medical necessity of the services rendered.

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 L02.13?

L02.13 specifically covers carbuncles located on the neck, which are characterized by multiple interconnected boils. It does not cover single boils (furuncles) or carbuncles located on other body parts.

When should L02.13 be used instead of related codes?

L02.13 should be used when the clinical presentation specifically indicates a carbuncle on the neck. If the infection is localized to another area, such as the trunk or limbs, the appropriate code should be selected based on the anatomical site.

What documentation supports L02.13?

Documentation should include a detailed description of the lesion, clinical findings, treatment provided, and any laboratory results if cultures were taken. Notes should clearly indicate the location and extent of the infection.