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ICD-10 Guide
ICD-10 CodesL02.212

L02.212

Billable

Cutaneous abscess of back [any part, except buttock]

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

Code Description

ICD-10 L02.212 is a billable code used to indicate a diagnosis of cutaneous abscess of back [any part, except buttock].

Key Diagnostic Point:

L02.212 refers to a cutaneous abscess located on the back, excluding the buttock area. A cutaneous abscess is a localized collection of pus within the dermis or subcutaneous tissue, typically resulting from bacterial infection, often due to Staphylococcus aureus. Clinically, patients may present with symptoms such as localized swelling, redness, warmth, and tenderness in the affected area. The abscess may also exhibit fluctuance, indicating the presence of pus. The anatomy involved includes the skin layers (epidermis, dermis) and subcutaneous tissue, which can become inflamed and infected. Disease progression can lead to systemic symptoms such as fever if the infection spreads. Diagnostic considerations include a thorough physical examination and, if necessary, imaging studies to assess the extent of the abscess. Aspiration or incision and drainage may be performed for both diagnostic and therapeutic purposes, and cultures may be taken to identify the causative organism. Proper identification and management are crucial to prevent complications such as cellulitis or systemic infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve procedures like incision and drainage.
  • Documentation requirements: Detailed clinical notes and procedure reports needed.
  • Coding specificity: Requires accurate localization and description of the abscess.

Audit Risk Factors

  • Common coding errors: Misidentifying the location of the abscess.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials if documentation does not support the procedure performed.

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 L02.212 lies in its potential to lead to more serious infections if not treated promptly. Population health impact includes the need for effective management of skin infections to reduce healthcare utilization and improve patient outcomes. Quality measures may focus on timely intervention and appropriate antibiotic use, while epidemiological considerations highlight the prevalence of skin infections in various demographics, emphasizing the importance of accurate coding and documentation.

ICD-9 vs ICD-10

The clinical significance of L02.212 lies in its potential to lead to more serious infections if not treated promptly. Population health impact includes the need for effective management of skin infections to reduce healthcare utilization and improve patient outcomes. Quality measures may focus on timely intervention and appropriate antibiotic use, while epidemiological considerations highlight the prevalence of skin infections in various demographics, emphasizing the importance of accurate coding and documentation.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure and the necessity of drainage. Common denials may arise from insufficient documentation or coding errors related to the abscess's location. Best practices include thorough clinical notes, ensuring that the procedure code matches the diagnosis, and verifying that all services rendered are documented appropriately to support claims.

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 L02.212?

L02.212 specifically covers cutaneous abscesses located on the back, excluding the buttock. This includes abscesses caused by bacterial infections, often presenting with localized symptoms such as pain, swelling, and redness.

When should L02.212 be used instead of related codes?

L02.212 should be used when the abscess is specifically located on the back and not on the buttock. If the abscess is on the buttock, L02.211 should be used instead.

What documentation supports L02.212?

Documentation should include a detailed description of the abscess's location, size, symptoms, and any procedures performed, such as drainage or aspiration. Clinical notes should also reflect the patient's history and any relevant imaging results.