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ICD-10 Guide
ICD-10 CodesL02.631

L02.631

Billable

Carbuncle of right foot

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

Code Description

ICD-10 L02.631 is a billable code used to indicate a diagnosis of carbuncle of right foot.

Key Diagnostic Point:

A carbuncle is a cluster of boils that form a painful, pus-filled infection in the skin and subcutaneous tissue. Specifically, L02.631 refers to a carbuncle located on the right foot. Clinically, carbuncles present as red, swollen lumps that may drain pus and are often accompanied by systemic symptoms such as fever and malaise. The anatomy involved includes the epidermis, dermis, and subcutaneous fat, where hair follicles become infected, leading to the formation of multiple interconnected abscesses. Disease progression can vary; if untreated, carbuncles may lead to complications such as cellulitis or systemic infection. Diagnostic considerations include a thorough clinical examination and, if necessary, cultures of the pus to identify the causative organism, typically Staphylococcus aureus. It is essential to differentiate carbuncles from other skin lesions such as furuncles, abscesses, and other dermatological conditions to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly 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 localization and understanding of the condition.

Audit Risk Factors

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

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, while localized infections, can have significant clinical implications if not treated promptly, potentially leading to systemic infections. Their occurrence can impact population health, particularly in communities with limited access to healthcare. Quality measures may include tracking the incidence of skin infections and ensuring timely treatment to reduce complications. Understanding the epidemiology of carbuncles can help healthcare providers implement preventive measures and improve patient outcomes.

ICD-9 vs ICD-10

Carbuncles, while localized infections, can have significant clinical implications if not treated promptly, potentially leading to systemic infections. Their occurrence can impact population health, particularly in communities with limited access to healthcare. Quality measures may include tracking the incidence of skin infections and ensuring timely treatment to reduce complications. Understanding the epidemiology of carbuncles can help healthcare providers implement preventive measures and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed, such as incision and drainage, and any associated office visits. Common denials may occur if the documentation does not adequately describe the condition or if the procedure is not clearly linked to the diagnosis. Best practices include thorough documentation of the clinical findings, treatment provided, and follow-up plans to support the medical necessity of 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 L02.631?

L02.631 specifically covers carbuncles located on the right foot, which are characterized by painful, swollen areas of skin that may drain pus. It is important to differentiate this from other skin infections such as furuncles or cellulitis.

When should L02.631 be used instead of related codes?

L02.631 should be used when the clinical presentation specifically indicates a carbuncle on the right foot. If the lesion is on the left foot, L02.632 should be used instead. Accurate localization is crucial for proper coding.

What documentation supports L02.631?

Documentation should include a detailed clinical examination, description of the lesion, any associated symptoms, treatment provided, and follow-up care. Cultures or lab results may also support the diagnosis.