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ICD-10 Guide
ICD-10 CodesL02.31

L02.31

Billable

Cutaneous abscess of buttock

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

Code Description

ICD-10 L02.31 is a billable code used to indicate a diagnosis of cutaneous abscess of buttock.

Key Diagnostic Point:

L02.31 refers to a cutaneous abscess of the buttock, which is a localized collection of pus within the dermis and subcutaneous tissue. Clinically, these abscesses present as painful, swollen areas that may be red, warm, and tender to touch. The underlying anatomy involved includes the skin layers, particularly the epidermis, dermis, and subcutaneous fat. Disease progression typically begins with an infection, often due to bacteria such as Staphylococcus aureus, leading to inflammation and pus formation. If untreated, the abscess can grow larger and may result in systemic symptoms such as fever and malaise. Diagnostic considerations include a thorough clinical 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: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve surgical intervention and antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and procedural documentation are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other skin infections.

Audit Risk Factors

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

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 L02.31 lies in its potential to lead to more severe infections if not treated promptly. Population health impact includes the need for timely intervention to prevent complications, which can increase healthcare utilization. Quality measures may focus on the timely diagnosis and management of skin infections, as well as patient education on prevention strategies. Epidemiologically, cutaneous abscesses are common, particularly in individuals with risk factors such as diabetes or immunocompromised states.

ICD-9 vs ICD-10

The clinical significance of L02.31 lies in its potential to lead to more severe infections if not treated promptly. Population health impact includes the need for timely intervention to prevent complications, which can increase healthcare utilization. Quality measures may focus on the timely diagnosis and management of skin infections, as well as patient education on prevention strategies. Epidemiologically, cutaneous abscesses are common, particularly in individuals with risk factors such as diabetes or immunocompromised states.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the procedure and the payer's policies. Common denials can occur if the documentation does not clearly establish the medical necessity for the procedure or if the abscess is not adequately described. Coders should ensure that all relevant clinical information is included to support the claim.

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 L02.31?

L02.31 specifically covers cutaneous abscesses located on the buttock, which may arise from various causes including bacterial infections, blocked sweat glands, or foreign bodies. It is essential to differentiate it from other skin infections such as cellulitis or furuncles.

When should L02.31 be used instead of related codes?

L02.31 should be used when the abscess is specifically located on the buttock. If the abscess is located elsewhere, such as the thigh or arm, the appropriate code should be selected based on the specific site of the abscess.

What documentation supports L02.31?

Documentation should include a detailed description of the abscess's location, size, and characteristics, as well as any associated symptoms. Clinical notes should also reflect the treatment provided, including any drainage procedures performed.