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ICD-10 Guide
ICD-10 CodesL02.234

L02.234

Billable

Carbuncle of groin

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

Code Description

ICD-10 L02.234 is a billable code used to indicate a diagnosis of carbuncle of groin.

Key Diagnostic Point:

A carbuncle of the groin is a painful cluster of boils that forms when hair follicles become infected, typically caused by Staphylococcus aureus bacteria. Clinically, it presents as a red, swollen area on the skin that may contain pus and is often accompanied by fever and malaise. The groin area, being prone to friction and moisture, is particularly susceptible to such infections. The disease progression can vary; initially, a small, painful lump may develop, which can grow larger and become more inflamed, leading to multiple interconnected abscesses. Diagnosis is primarily clinical, based on the appearance of the lesion and associated symptoms. In some cases, laboratory tests such as cultures may be performed to identify the causative organism. Differential diagnoses include other skin infections like folliculitis, hidradenitis suppurativa, and abscesses. Prompt diagnosis and treatment are crucial to prevent complications such as systemic infection or scarring.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and may involve lab tests.
  • Treatment complexity: May require incision and drainage, antibiotics, and follow-up care.
  • Documentation requirements: Detailed clinical notes and treatment plans are necessary.
  • Coding specificity: Requires accurate identification of the site and type of infection.

Audit Risk Factors

  • Common coding errors: Misidentifying the site of infection or using a more general code.
  • Documentation gaps: Incomplete clinical notes regarding the extent of infection.
  • Billing challenges: Potential denials if the necessity of procedures is not well-documented.

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: 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Carbuncles, particularly in the groin area, can significantly impact patient quality of life due to pain and discomfort. They may lead to increased healthcare utilization, including emergency visits and surgical interventions. Understanding the epidemiology of skin infections like carbuncles is crucial for public health, as they can indicate broader issues related to hygiene and community health. Effective management and prevention strategies can reduce the incidence of such infections.

ICD-9 vs ICD-10

Carbuncles, particularly in the groin area, can significantly impact patient quality of life due to pain and discomfort. They may lead to increased healthcare utilization, including emergency visits and surgical interventions. Understanding the epidemiology of skin infections like carbuncles is crucial for public health, as they can indicate broader issues related to hygiene and community health. Effective management and prevention strategies can reduce the incidence of such infections.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the case and whether the treatment involved surgical intervention. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures. Best practices include ensuring that all clinical notes are thorough and that coding accurately reflects the services provided.

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 L02.234?

L02.234 specifically covers carbuncles located in the groin area, which are characterized by multiple interconnected boils that arise from infected hair follicles. It is important to differentiate this from other skin infections such as abscesses or folliculitis.

When should L02.234 be used instead of related codes?

L02.234 should be used when the clinical presentation specifically indicates a carbuncle in the groin. If the infection is localized to another area, such as the neck or face, the corresponding codes L02.232 or L02.233 should be utilized.

What documentation supports L02.234?

Documentation should include a detailed clinical examination, description of the lesion, any associated symptoms, treatment provided, and follow-up care. Laboratory results, if obtained, should also be included to support the diagnosis.