ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesL12.31

L12.31

Billable

Epidermolysis bullosa due to drug

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

Code Description

ICD-10 L12.31 is a billable code used to indicate a diagnosis of epidermolysis bullosa due to drug.

Key Diagnostic Point:

Epidermolysis bullosa due to drug is a rare dermatological condition characterized by the formation of blisters and erosions on the skin and mucous membranes, triggered by specific medications. Clinically, patients may present with fragile skin that easily blisters in response to minor trauma or friction, leading to painful lesions. The anatomy involved primarily includes the epidermis and dermis, where the structural integrity is compromised due to the adverse drug reaction. Disease progression can vary, with some patients experiencing acute episodes that resolve upon discontinuation of the offending drug, while others may develop chronic skin changes. Diagnostic considerations include a thorough patient history to identify potential drug exposures, clinical examination of skin lesions, and possibly skin biopsy to rule out other forms of epidermolysis bullosa. Laboratory tests may also be warranted to assess for underlying conditions or to confirm the diagnosis. Accurate diagnosis is crucial for effective management and prevention of further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful differentiation from other forms of epidermolysis bullosa and skin disorders.
  • Treatment complexity: Involves identifying and discontinuing the causative drug, along with symptomatic management of skin lesions.
  • Documentation requirements: Detailed documentation of drug history, clinical findings, and treatment response is essential.
  • Coding specificity: Requires precise coding to reflect the drug-induced nature of the condition.

Audit Risk Factors

  • Common coding errors: Misclassification of drug-induced epidermolysis bullosa as other types.
  • Documentation gaps: Incomplete drug history or lack of detailed clinical notes.
  • Billing challenges: Potential denials if the relationship between the drug and skin condition is not clearly established.

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

Pharmacology

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 L12.31 lies in its potential to cause significant morbidity due to skin fragility and the risk of secondary infections. Understanding the epidemiology of drug-induced epidermolysis bullosa is crucial for healthcare providers, as it can influence treatment decisions and patient management strategies. Population health impact includes the need for awareness among prescribers regarding the potential dermatological side effects of medications, which can lead to improved patient outcomes and reduced healthcare utilization.

ICD-9 vs ICD-10

The clinical significance of L12.31 lies in its potential to cause significant morbidity due to skin fragility and the risk of secondary infections. Understanding the epidemiology of drug-induced epidermolysis bullosa is crucial for healthcare providers, as it can influence treatment decisions and patient management strategies. Population health impact includes the need for awareness among prescribers regarding the potential dermatological side effects of medications, which can lead to improved patient outcomes and reduced healthcare utilization.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the coding accurately reflects the drug-induced nature of the condition. Common denials may arise if there is insufficient documentation linking the skin condition to a specific medication. Best practices include maintaining thorough clinical notes and ensuring that all relevant details are captured in the medical record to support the diagnosis and treatment provided.

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 L12.31?

L12.31 specifically covers cases of epidermolysis bullosa that are directly attributable to adverse drug reactions. This includes conditions where patients develop blistering and skin fragility following the administration of certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, or chemotherapeutic agents.

When should L12.31 be used instead of related codes?

L12.31 should be used when there is clear evidence linking the epidermolysis bullosa to a specific drug exposure. If the condition arises without any known drug association, other codes for non-drug-induced epidermolysis bullosa should be considered.

What documentation supports L12.31?

Documentation for L12.31 should include a detailed patient history highlighting drug exposures, clinical descriptions of skin lesions, treatment responses, and any relevant laboratory findings that support the diagnosis of drug-induced epidermolysis bullosa.