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ICD-10 Guide
ICD-10 CodesChapter 12: Diseases of the skin and subcutaneous tissueL72

L72

Non-billable

Follicular cysts of skin and subcutaneous tissue

Chapter 12:Diseases of the skin and subcutaneous tissue

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

Code Description

ICD-10 L72 is a used to indicate a diagnosis of follicular cysts of skin and subcutaneous tissue.

Key Diagnostic Point:

Follicular cysts of the skin and subcutaneous tissue, classified under ICD-10 code L72, are benign cystic lesions that arise from hair follicles. These cysts are typically filled with keratin and can vary in size from a few millimeters to several centimeters. Clinically, they present as firm, mobile nodules located primarily on the scalp, face, neck, and trunk. The cysts may be asymptomatic but can become inflamed or infected, leading to pain and discomfort. The anatomy involved includes the epidermis and dermis, where the hair follicle originates. Disease progression is generally slow, and while these cysts are benign, they can recur after excision. Diagnostic considerations include a thorough clinical examination and, if necessary, imaging studies to differentiate them from other skin lesions. A biopsy may be performed to confirm the diagnosis if there is uncertainty regarding the nature of the cyst.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate; requires clinical evaluation and sometimes imaging.
  • Treatment complexity: Low; typically involves simple excision.
  • Documentation requirements: Moderate; requires detailed clinical notes and possibly histopathology reports.
  • Coding specificity: Medium; specific to follicular cysts but may overlap with other skin lesions.

Audit Risk Factors

  • Common coding errors: Misclassification with other skin lesions.
  • Documentation gaps: Incomplete clinical notes regarding the cyst's characteristics.
  • Billing challenges: Potential denials if the cyst is not documented as symptomatic or if excision is not justified.

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

General Surgery

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 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

Follicular cysts, while generally benign, can impact patient quality of life if they become symptomatic or infected. Their prevalence in the population highlights the importance of proper diagnosis and treatment. Understanding the epidemiology of these cysts can aid in recognizing patterns of healthcare utilization, particularly in dermatology and surgical settings. Quality measures may include tracking the rate of complications post-excision and patient satisfaction with treatment outcomes.

ICD-9 vs ICD-10

Follicular cysts, while generally benign, can impact patient quality of life if they become symptomatic or infected. Their prevalence in the population highlights the importance of proper diagnosis and treatment. Understanding the epidemiology of these cysts can aid in recognizing patterns of healthcare utilization, particularly in dermatology and surgical settings. Quality measures may include tracking the rate of complications post-excision and patient satisfaction with treatment outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the procedure performed is medically necessary, especially if the cyst is asymptomatic. Common denials may arise if the procedure is deemed cosmetic or if there is insufficient documentation. Best practices include maintaining thorough clinical notes, ensuring proper coding specificity, and confirming that the excision is justified based on symptoms or complications.

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 L72?

L72 covers follicular cysts, primarily epidermoid cysts, which are keratin-filled lesions arising from hair follicles. It does not include other types of cysts such as pilar cysts or sebaceous cysts, which may be coded differently.

When should L72 be used instead of related codes?

L72 should be used specifically for follicular cysts when the clinical presentation aligns with this diagnosis. If the cyst is of a different origin or type, such as a sebaceous cyst (L71), the appropriate code should be selected.

What documentation supports L72?

Documentation should include a detailed clinical description of the cyst, its location, size, symptoms (if any), and any imaging or biopsy results that confirm the diagnosis.