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ICD-10 Guide
ICD-10 CodesL50.6

L50.6

Billable

Contact urticaria

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

Code Description

ICD-10 L50.6 is a billable code used to indicate a diagnosis of contact urticaria.

Key Diagnostic Point:

Contact urticaria is a localized hypersensitivity reaction characterized by the development of wheals, erythema, and pruritus following direct contact with an allergen. The skin involved typically includes the area that has been exposed to the triggering substance, which can range from natural proteins (like those found in certain foods) to synthetic chemicals (such as those in cosmetics or cleaning products). The clinical presentation can vary from mild localized reactions to more severe systemic responses, depending on the individual's sensitivity and the nature of the allergen. Disease progression often involves the immediate onset of symptoms, usually within minutes to hours after exposure, and can resolve quickly once the allergen is removed. Diagnostic considerations include a thorough patient history, identification of potential allergens, and, in some cases, skin prick tests or patch testing to confirm sensitivities. It is essential for healthcare providers to differentiate contact urticaria from other forms of urticaria and dermatitis to ensure appropriate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful history-taking and potential allergen testing.
  • Treatment complexity: Management may involve avoidance of triggers and antihistamines.
  • Documentation requirements: Detailed documentation of symptoms, triggers, and treatment response is necessary.
  • Coding specificity: Requires precise coding to differentiate from other urticaria types.

Audit Risk Factors

  • Common coding errors: Misclassification with other urticaria codes.
  • Documentation gaps: Incomplete patient history or lack of allergen identification.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

Allergy and Immunology

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

Contact urticaria has significant clinical implications, particularly for individuals with occupational or environmental exposures. Understanding this condition can improve population health outcomes by promoting awareness of allergens and preventive measures. Quality measures may include tracking the incidence of contact urticaria in specific populations, which can inform healthcare utilization patterns and guide public health initiatives aimed at reducing allergen exposure.

ICD-9 vs ICD-10

Contact urticaria has significant clinical implications, particularly for individuals with occupational or environmental exposures. Understanding this condition can improve population health outcomes by promoting awareness of allergens and preventive measures. Quality measures may include tracking the incidence of contact urticaria in specific populations, which can inform healthcare utilization patterns and guide public health initiatives aimed at reducing allergen exposure.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, but it is crucial to ensure that the diagnosis is well-supported by clinical evidence. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include maintaining thorough records of patient interactions, treatment plans, and follow-up assessments to substantiate the medical necessity of 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 L50.6?

L50.6 specifically covers contact urticaria, which can be triggered by various allergens including foods, medications, and environmental substances. It is important to document the specific allergen when applicable.

When should L50.6 be used instead of related codes?

L50.6 should be used when the urticaria is directly linked to contact with an allergen, as opposed to other forms of urticaria that may not have a direct contact trigger.

What documentation supports L50.6?

Documentation should include a detailed history of exposure to potential allergens, the timing and nature of the reaction, and any diagnostic tests performed to confirm the allergen.