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ICD-10 Guide
ICD-10 CodesL02.92

L02.92

Billable

Furuncle, unspecified

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

Code Description

ICD-10 L02.92 is a billable code used to indicate a diagnosis of furuncle, unspecified.

Key Diagnostic Point:

Furuncle, also known as a boil, is a painful, pus-filled bump that forms under the skin when hair follicles become infected, typically by Staphylococcus aureus bacteria. The condition primarily affects areas of the skin that are prone to friction and sweating, such as the neck, armpits, buttocks, and thighs. Clinically, furuncles present as red, swollen nodules that may eventually rupture and drain pus. The disease progression can vary; while some furuncles resolve spontaneously, others may require medical intervention, especially if they are recurrent or associated with systemic symptoms like fever. Diagnostic considerations include a thorough clinical examination and, in some cases, culture of the pus to identify the causative organism. It is important to differentiate furuncles from other skin lesions such as carbuncles, abscesses, and cellulitis, which may require different management strategies. Proper diagnosis and treatment are essential to prevent complications such as the spread of infection or the development of chronic skin conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other skin infections.
  • Treatment complexity: Moderate, as treatment may involve incision and drainage or antibiotics.
  • Documentation requirements: Moderate, necessitating detailed clinical notes and possibly culture results.
  • Coding specificity: Medium, as it is specific to furuncles but lacks detail on location or severity.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin infections or abscesses.
  • Documentation gaps: Incomplete clinical notes regarding the site, size, and treatment of the furuncle.
  • Billing challenges: Potential denials if the documentation does not clearly 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: Family Medicine

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, leading to pain, discomfort, and potential complications if left untreated. They are common in populations with higher rates of skin infections, such as those with diabetes or immunocompromised states. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve patient outcomes through timely intervention and education on skin hygiene.

ICD-9 vs ICD-10

Furuncles can significantly impact patient quality of life, leading to pain, discomfort, and potential complications if left untreated. They are common in populations with higher rates of skin infections, such as those with diabetes or immunocompromised states. Understanding the epidemiology of furuncles can help healthcare providers implement preventive measures and improve patient outcomes through timely intervention and education on skin hygiene.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed notes on the clinical presentation and treatment provided. Common denials may arise if the documentation does not adequately describe the condition or if the procedure performed is not clearly linked to the diagnosis. Best practices include using precise language in clinical notes and ensuring that any procedures, such as incision and drainage, are well-documented to support the billing process.

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 L02.92?

L02.92 covers unspecified furuncles, which are localized skin infections typically caused by bacteria. It does not specify the location or severity of the furuncle, making it a general code for cases where the exact details are not documented.

When should L02.92 be used instead of related codes?

L02.92 should be used when a furuncle is diagnosed but the specific site is not documented or when the furuncle does not fit the criteria for more specific codes like L02.91 or L02.93.

What documentation supports L02.92?

Documentation should include a detailed clinical examination, description of the lesion, treatment provided, and any laboratory results if cultures were taken. Clear notes on the patient's history of skin infections may also support the diagnosis.