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ICD-10 Guide
ICD-10 CodesL02.42

L02.42

Non-billable

Furuncle of limb

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

Code Description

ICD-10 L02.42 is a used to indicate a diagnosis of furuncle of limb.

Key Diagnostic Point:

A furuncle, commonly known as a boil, is a painful, pus-filled bump that forms under the skin when hair follicles become infected with bacteria, typically Staphylococcus aureus. Furuncles can occur anywhere on the body but are most common on the limbs, particularly in areas where friction or sweating occurs. Clinically, they present as red, swollen nodules that may eventually rupture and drain pus. The underlying anatomy involved includes the hair follicle, sebaceous glands, and surrounding subcutaneous tissue. Disease progression can vary; while some furuncles resolve spontaneously, others may lead to complications such as abscess formation or systemic infection if not treated appropriately. Diagnostic considerations include a thorough clinical examination and, in some cases, culture of the pus to identify the causative organism. Differential diagnoses may include carbuncles, folliculitis, or other skin infections, necessitating careful evaluation to ensure accurate coding and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and sometimes laboratory confirmation.
  • Treatment complexity: May involve incision and drainage, antibiotics, or surgical intervention.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential.
  • Coding specificity: Requires precise coding to differentiate from similar conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin infections.
  • Documentation gaps: Incomplete clinical notes regarding the extent of infection.
  • Billing challenges: Potential denials if treatment is deemed unnecessary or not well-documented.

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

Furuncles can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. They are common in populations with higher incidences of skin infections, such as those with diabetes or compromised immune systems. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve overall population health outcomes.

ICD-9 vs ICD-10

Furuncles can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. They are common in populations with higher incidences of skin infections, such as those with diabetes or compromised immune systems. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve overall population health outcomes.

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 if the documentation does not clearly support the necessity of the procedure or if the diagnosis is not well-defined. Best practices include ensuring that all clinical notes are thorough and that coding accurately reflects the services rendered.

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 L02.42?

L02.42 specifically covers furuncles located on the limbs, which are characterized by localized infections of hair follicles leading to painful, pus-filled lesions. It does not include other types of skin infections or lesions.

When should L02.42 be used instead of related codes?

L02.42 should be used when documenting a furuncle specifically on a limb. If the infection is on the face or trunk, the appropriate codes L02.41 or L02.43 should be selected. Accurate anatomical localization is crucial for correct coding.

What documentation supports L02.42?

Documentation should include a detailed clinical assessment of the lesion, including size, location, symptoms, and any treatment provided. Notes on the patient's history of skin infections and any relevant laboratory results, such as cultures, should also be included.