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ICD-10 Guide
ICD-10 CodesL02.215

L02.215

Billable

Cutaneous abscess of perineum

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

Code Description

ICD-10 L02.215 is a billable code used to indicate a diagnosis of cutaneous abscess of perineum.

Key Diagnostic Point:

L02.215 refers to a cutaneous abscess located in the perineum, which is the area between the anus and the genitals. This condition typically presents as a painful, swollen, and erythematous lesion that may be fluctuant, indicating the presence of pus. The abscess can arise from various causes, including bacterial infections, blocked sweat glands, or hair follicles. The anatomy involved includes the skin and subcutaneous tissue of the perineal region, which is rich in hair follicles and sebaceous glands, making it susceptible to infections. Disease progression can lead to increased pain, systemic symptoms like fever, and potential complications if left untreated, such as cellulitis or systemic infection. Diagnostic considerations include a thorough clinical examination, history-taking to identify risk factors (such as diabetes or immunosuppression), and possibly imaging studies if deeper tissue involvement is suspected. Culturing the pus may also be necessary to identify the causative organism and guide antibiotic therapy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve incision and drainage, along with antibiotic therapy.
  • Documentation requirements: Detailed documentation of clinical findings and treatment plans is essential.
  • Coding specificity: Specific to cutaneous abscess in the perineum, necessitating accurate coding.

Audit Risk Factors

  • Common coding errors: Misclassification of abscess location or type.
  • Documentation gaps: Incomplete clinical notes regarding the abscess characteristics.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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 L02.215 lies in its potential to cause discomfort and complications if not addressed promptly. In terms of population health, perineal abscesses can affect individuals with certain risk factors, such as obesity or diabetes, leading to increased healthcare utilization. Quality measures may include timely diagnosis and treatment, which can improve patient outcomes and reduce the risk of complications. Understanding the epidemiology of cutaneous abscesses can help healthcare providers implement preventive measures and improve overall patient care.

ICD-9 vs ICD-10

The clinical significance of L02.215 lies in its potential to cause discomfort and complications if not addressed promptly. In terms of population health, perineal abscesses can affect individuals with certain risk factors, such as obesity or diabetes, leading to increased healthcare utilization. Quality measures may include timely diagnosis and treatment, which can improve patient outcomes and reduce the risk of complications. Understanding the epidemiology of cutaneous abscesses can help healthcare providers implement preventive measures and improve overall patient care.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and the necessity for follow-up care. Common denials may arise from insufficient documentation or coding errors, so it is crucial to provide clear clinical notes that detail the patient's condition and treatment. Best practices include using precise coding, ensuring all relevant details are documented, and verifying that the procedure aligns with the diagnosis.

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 L02.215?

L02.215 specifically covers cutaneous abscesses located in the perineum, which may arise from infections, blocked glands, or other dermatological conditions leading to localized pus formation.

When should L02.215 be used instead of related codes?

L02.215 should be used when the abscess is specifically located in the perineum. If the abscess is located in another area, such as the buttock or thigh, the corresponding codes L02.211 or L02.212 should be used.

What documentation supports L02.215?

Documentation should include a detailed description of the abscess, including its size, tenderness, fluctuation, and any systemic symptoms. Treatment plans and follow-up notes are also critical.