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ICD-10 Guide
ICD-10 CodesL02.235

L02.235

Billable

Carbuncle of perineum

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

Code Description

ICD-10 L02.235 is a billable code used to indicate a diagnosis of carbuncle of perineum.

Key Diagnostic Point:

A carbuncle of the perineum is a painful cluster of boils that occurs in the skin and subcutaneous tissue, typically caused by bacterial infection, most commonly Staphylococcus aureus. Clinically, it presents as a red, swollen area that may contain pus and is often accompanied by systemic symptoms such as fever and malaise. The perineum, being a sensitive area, can lead to significant discomfort and complications if not treated promptly. The disease progression may involve the formation of multiple interconnected abscesses, which can drain spontaneously or require surgical intervention. Diagnostic considerations include a thorough clinical examination and, if necessary, cultures to identify the causative organism. Differential diagnoses may include other skin infections such as folliculitis or abscesses in adjacent areas. Proper identification and management are crucial to prevent further complications, including systemic infection or recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possible culture.
  • Treatment complexity: May involve antibiotics and/or surgical drainage.
  • Documentation requirements: Detailed clinical notes on symptoms and treatment.
  • Coding specificity: Requires accurate identification of the site and type of infection.

Audit Risk Factors

  • Common coding errors: Misidentifying the site or type of infection.
  • Documentation gaps: Incomplete records regarding the extent of the infection.
  • Billing challenges: Potential denials if the documentation does not support the diagnosis.

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 in the perineum can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. They are more prevalent in populations with compromised immune systems or poor hygiene practices. Understanding the epidemiology of skin infections like carbuncles is crucial for public health initiatives aimed at reducing incidence rates and improving patient outcomes.

ICD-9 vs ICD-10

Carbuncles in the perineum can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. They are more prevalent in populations with compromised immune systems or poor hygiene practices. Understanding the epidemiology of skin infections like carbuncles is crucial for public health initiatives aimed at reducing incidence rates and improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of surgical intervention, if performed, and the use of appropriate CPT codes for drainage procedures. Common denials may arise from insufficient documentation or misclassification of the condition. Coders should ensure that all relevant clinical details are included in the medical record to support the diagnosis and treatment 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 L02.235?

L02.235 specifically covers carbuncles located in the perineal area, which are characterized by multiple interconnected abscesses and can lead to significant pain and systemic symptoms.

When should L02.235 be used instead of related codes?

L02.235 should be used when the carbuncle is specifically located in the perineum, differentiating it from carbuncles in other anatomical locations, such as the trunk or limbs.

What documentation supports L02.235?

Documentation should include a detailed clinical assessment of the lesion, treatment provided, and any laboratory results, such as cultures, that confirm the diagnosis.