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v1.0.0
ICD-10 Guide
ICD-10 CodesL44.0

L44.0

Billable

Pityriasis rubra pilaris

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

Code Description

ICD-10 L44.0 is a billable code used to indicate a diagnosis of pityriasis rubra pilaris.

Key Diagnostic Point:

Pityriasis rubra pilaris (PRP) is a chronic inflammatory skin disorder characterized by the presence of reddish-orange patches and plaques, often with a scaly appearance. The condition primarily affects the hair follicles, leading to the formation of keratotic plugs. PRP can present in various forms, with the classic type showing well-defined plaques on the scalp, face, and extremities, while other variants may involve widespread skin lesions. The disease progression can vary, with some patients experiencing spontaneous remission, while others may have persistent symptoms. The exact etiology of PRP remains unclear, but it is believed to involve an autoimmune component. Diagnostic considerations include a thorough clinical examination and, in some cases, skin biopsy to rule out other dermatological conditions such as psoriasis or eczema. Laboratory tests may be conducted to assess for associated systemic conditions, particularly in atypical presentations. Understanding the clinical presentation and progression of PRP is crucial for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other skin disorders.
  • Treatment complexity: May involve systemic therapies and monitoring.
  • Documentation requirements: Detailed clinical notes and follow-up assessments needed.
  • Coding specificity: Requires accurate coding to reflect the specific type of PRP.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin disorders.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials due to lack of specificity in coding.

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

Pityriasis rubra pilaris can significantly affect patients' quality of life due to its chronic nature and visible skin lesions. Understanding its epidemiology is essential for healthcare providers, as it may impact population health initiatives aimed at managing skin disorders. Quality measures should focus on timely diagnosis and effective treatment strategies to improve patient outcomes and reduce healthcare utilization related to complications from untreated PRP.

ICD-9 vs ICD-10

Pityriasis rubra pilaris can significantly affect patients' quality of life due to its chronic nature and visible skin lesions. Understanding its epidemiology is essential for healthcare providers, as it may impact population health initiatives aimed at managing skin disorders. Quality measures should focus on timely diagnosis and effective treatment strategies to improve patient outcomes and reduce healthcare utilization related to complications from untreated PRP.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the case and the treatment provided. Common denials can occur if the documentation does not clearly establish the diagnosis or if the services rendered are not adequately justified. Best practices include maintaining thorough records and ensuring that all coding aligns with the clinical findings.

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 L44.0?

L44.0 specifically covers pityriasis rubra pilaris, a distinct condition characterized by keratotic follicular papules and erythematous plaques. It is important to differentiate it from other similar skin conditions such as psoriasis and eczema.

When should L44.0 be used instead of related codes?

L44.0 should be used when the clinical presentation aligns with pityriasis rubra pilaris, particularly when the characteristic symptoms and lesions are present. It is essential to document the specific features that distinguish it from other skin disorders.

What documentation supports L44.0?

Documentation should include a detailed clinical history, physical examination findings, and any diagnostic tests performed. A skin biopsy may be necessary to confirm the diagnosis and rule out other conditions.