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ICD-10 Guide
ICD-10 CodesL02.811

L02.811

Billable

Cutaneous abscess of head [any part, except face]

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

Code Description

ICD-10 L02.811 is a billable code used to indicate a diagnosis of cutaneous abscess of head [any part, except face].

Key Diagnostic Point:

L02.811 refers to a cutaneous abscess located on the head, excluding the face. This condition is characterized by a localized collection of pus within the skin or subcutaneous tissue, often resulting from bacterial infection, typically Staphylococcus aureus. Clinically, patients may present with swelling, redness, tenderness, and warmth over the affected area, along with possible systemic symptoms such as fever. The anatomy involved includes the epidermis, dermis, and subcutaneous layers of the scalp or other parts of the head. Disease progression can lead to complications if left untreated, including the potential for systemic infection or the development of chronic abscesses. Diagnostic considerations include physical examination, imaging studies if necessary, and laboratory tests to identify the causative organism. Proper identification of the abscess location is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly imaging.
  • Treatment complexity: May involve incision and drainage, antibiotic therapy.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential.
  • Coding specificity: Requires accurate identification of the abscess location.

Audit Risk Factors

  • Common coding errors: Misidentification of abscess location.
  • Documentation gaps: Incomplete clinical notes regarding the abscess characteristics.
  • Billing challenges: Potential denials if 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: 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 L02.811 lies in its potential to cause discomfort and systemic infection if not properly managed. Understanding the epidemiology of cutaneous abscesses can inform public health strategies, as these conditions are prevalent in various populations. Quality measures may include tracking the incidence of abscesses and the effectiveness of treatment protocols, which can impact healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

The clinical significance of L02.811 lies in its potential to cause discomfort and systemic infection if not properly managed. Understanding the epidemiology of cutaneous abscesses can inform public health strategies, as these conditions are prevalent in various populations. Quality measures may include tracking the incidence of abscesses and the effectiveness of treatment protocols, which can impact healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the procedure performed and the patient's insurance coverage. Documentation must clearly outline the clinical findings, treatment provided, and any follow-up care. Common denials may arise from insufficient documentation or incorrect coding of the abscess location. Best practices include ensuring that all clinical notes are complete and that the coding reflects the specific site and nature of the abscess.

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 L02.811?

L02.811 covers cutaneous abscesses located on the head, excluding the face. This includes abscesses resulting from infections, trauma, or other dermatological conditions that lead to localized pus formation.

When should L02.811 be used instead of related codes?

L02.811 should be used when the abscess is specifically located on the head and not on the face. If the abscess is on the face, L02.812 should be selected instead.

What documentation supports L02.811?

Documentation should include a thorough clinical examination note, details of the abscess characteristics (size, location, signs of infection), treatment provided, and any laboratory results if cultures were taken.