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ICD-10 Guide
ICD-10 CodesL02.214

L02.214

Billable

Cutaneous abscess of groin

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

Code Description

ICD-10 L02.214 is a billable code used to indicate a diagnosis of cutaneous abscess of groin.

Key Diagnostic Point:

L02.214 refers to a cutaneous abscess located in the groin area, which is an accumulation of pus within the dermis and subcutaneous tissue. Clinically, patients may present with localized swelling, redness, warmth, and tenderness in the groin region, often accompanied by systemic symptoms such as fever and malaise. The groin is anatomically significant as it contains lymph nodes, blood vessels, and nerves, making it a potential site for infections that can lead to abscess formation. The disease progression typically begins with a localized infection, often due to bacteria such as Staphylococcus aureus, leading to inflammation and subsequent pus formation. Diagnostic considerations include 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. 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
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the location of the abscess.
  • Documentation gaps may arise if the clinical notes do not clearly specify the site and nature of the abscess.
  • Billing challenges can occur if the procedure performed is not adequately documented or if the diagnosis does not support 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 L02.214 lies in its potential to lead to serious complications if not treated promptly, including systemic infections. The population health impact is notable, as skin and soft tissue infections are common and can affect a wide demographic. Quality measures focus on timely diagnosis and treatment, which can reduce healthcare utilization patterns and improve patient outcomes. Epidemiologically, understanding the prevalence of cutaneous abscesses in the groin can aid in public health initiatives aimed at infection prevention.

ICD-9 vs ICD-10

The clinical significance of L02.214 lies in its potential to lead to serious complications if not treated promptly, including systemic infections. The population health impact is notable, as skin and soft tissue infections are common and can affect a wide demographic. Quality measures focus on timely diagnosis and treatment, which can reduce healthcare utilization patterns and improve patient outcomes. Epidemiologically, understanding the prevalence of cutaneous abscesses in the groin can aid in public health initiatives aimed at infection prevention.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure and whether it was performed in an outpatient or inpatient setting. Common denials may arise from insufficient documentation or coding errors. Best practices include thorough clinical notes that detail the patient's condition, the rationale for the procedure, and any follow-up care provided. Accurate coding and clear documentation can help mitigate audit risks and ensure proper reimbursement.

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 L02.214?

L02.214 specifically covers cutaneous abscesses located in the groin area, which may arise from various causes including bacterial infections, folliculitis, or trauma. It is important to differentiate it from other skin infections such as cellulitis or furuncles.

When should L02.214 be used instead of related codes?

L02.214 should be used when the abscess is specifically located in the groin. If the abscess is located in another area, such as the buttock or thigh, the corresponding codes (e.g., L02.213) should be utilized.

What documentation supports L02.214?

Documentation should include a detailed description of the abscess, including its location, size, and any associated symptoms. Clinical notes should also reflect the treatment provided, such as drainage or antibiotic therapy, and any relevant laboratory results.