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ICD-10 Guide
ICD-10 CodesL70.4

L70.4

Billable

Infantile acne

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

Code Description

ICD-10 L70.4 is a billable code used to indicate a diagnosis of infantile acne.

Key Diagnostic Point:

Infantile acne, also known as neonatal acne, is a common dermatological condition that typically presents in infants aged 3 weeks to 6 months. Clinically, it manifests as small, red papules and pustules primarily on the face, particularly on the cheeks, forehead, and chin. The condition arises due to the stimulation of sebaceous glands by maternal hormones, leading to increased sebum production. The lesions are generally self-limiting and resolve spontaneously within a few months without scarring. Differential diagnosis includes other forms of acne, such as acne vulgaris, and conditions like milia or seborrheic dermatitis. Diagnostic considerations involve a thorough clinical examination, and in atypical cases, a review of the infant's medical history and family history may be warranted to rule out other underlying conditions. While infantile acne is not typically associated with significant morbidity, it can cause parental concern due to its appearance.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Diagnostic complexity: Low - typically diagnosed based on clinical presentation
  • Treatment complexity: Low - often self-resolving, minimal intervention needed
  • Documentation requirements: Low - straightforward documentation of clinical findings
  • Coding specificity: Medium - specific to infantile acne but differentiates from other acne types

Audit Risk Factors

  • Common coding errors: Misclassification with other acne types
  • Documentation gaps: Incomplete patient history or clinical findings
  • Billing challenges: Lack of clear treatment plans may lead to denials

Specialty Focus

Medical Specialties

Pediatrics

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

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

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

Infantile acne, while generally benign, can impact parental anxiety and healthcare utilization due to concerns about the infant's skin condition. Understanding its prevalence and management is crucial for pediatric care providers. Quality measures may include monitoring the frequency of unnecessary treatments or referrals to dermatology, as most cases resolve spontaneously. Epidemiologically, infantile acne is common, affecting a significant proportion of infants, highlighting the need for awareness and education among healthcare providers.

ICD-9 vs ICD-10

Infantile acne, while generally benign, can impact parental anxiety and healthcare utilization due to concerns about the infant's skin condition. Understanding its prevalence and management is crucial for pediatric care providers. Quality measures may include monitoring the frequency of unnecessary treatments or referrals to dermatology, as most cases resolve spontaneously. Epidemiologically, infantile acne is common, affecting a significant proportion of infants, highlighting the need for awareness and education among healthcare providers.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical findings. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include maintaining thorough records of patient encounters and ensuring that the diagnosis aligns with the 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 L70.4?

L70.4 specifically covers infantile acne, characterized by papules and pustules in infants, typically resolving without treatment. It does not include other acne forms like acne vulgaris or cystic acne.

When should L70.4 be used instead of related codes?

L70.4 should be used when diagnosing acne specifically in infants under 6 months of age. It is essential to differentiate it from other acne types that may require different management.

What documentation supports L70.4?

Documentation should include clinical findings of acne lesions, patient age, and any relevant maternal history. Photographic evidence may also support the diagnosis.