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ICD-10 Guide
ICD-10 CodesL02.4

L02.4

Non-billable

Cutaneous abscess, furuncle and carbuncle of limb

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

Code Description

ICD-10 L02.4 is a used to indicate a diagnosis of cutaneous abscess, furuncle and carbuncle of limb.

Key Diagnostic Point:

L02.4 refers to cutaneous abscesses, furuncles, and carbuncles specifically located on the limbs. These conditions are characterized by localized collections of pus within the dermis and subcutaneous tissue, often resulting from bacterial infections, most commonly Staphylococcus aureus. Clinically, patients may present with painful, swollen areas that may be red, warm, and tender to touch. Furuncles, or boils, are typically single lesions, while carbuncles are larger, interconnected abscesses that can involve multiple hair follicles. The disease progression can lead to systemic symptoms such as fever if the infection spreads. Diagnostic considerations include physical examination and, in some cases, culture of the pus to identify the causative organism. Imaging studies are rarely required unless there is suspicion of deeper tissue involvement. 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 sometimes laboratory tests.
  • Treatment complexity: May involve 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 lesion type and location.

Audit Risk Factors

  • Common coding errors: Misidentifying the type of abscess or its location.
  • Documentation gaps: Incomplete clinical notes regarding the treatment and follow-up.
  • Billing challenges: Denials may occur 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

Primary Care

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 L02.4 lies in its potential to lead to more severe infections if not treated promptly. Population health impact includes the need for effective management of skin infections to reduce healthcare utilization and prevent complications. Quality measures may involve tracking the incidence of these conditions and ensuring appropriate treatment protocols are followed. Epidemiologically, these conditions are prevalent in various demographics, highlighting the importance of awareness and preventive measures in community health.

ICD-9 vs ICD-10

The clinical significance of L02.4 lies in its potential to lead to more severe infections if not treated promptly. Population health impact includes the need for effective management of skin infections to reduce healthcare utilization and prevent complications. Quality measures may involve tracking the incidence of these conditions and ensuring appropriate treatment protocols are followed. Epidemiologically, these conditions are prevalent in various demographics, highlighting the importance of awareness and preventive measures in community health.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and whether antibiotics were prescribed. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant details are captured in the medical record to support the billed services.

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 L02.4?

L02.4 covers cutaneous abscesses, furuncles, and carbuncles located on the limbs. These conditions are characterized by localized infections that lead to pus formation in the skin and subcutaneous tissue.

When should L02.4 be used instead of related codes?

L02.4 should be used when the abscess, furuncle, or carbuncle is specifically located on the limbs. If the lesions are on other body parts, such as the trunk or face, different codes should be selected.

What documentation supports L02.4?

Documentation should include a detailed description of the lesion, its location, size, and any systemic symptoms. Treatment notes, including incision and drainage procedures and antibiotic prescriptions, are also essential.