ICD-10 Coding for Acne(L70.0, L70.1, L70.5)
Complete ICD-10-CM coding and documentation guide for Acne. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acne
L70-L70.9Primary Range
Acne
This range covers all types of acne, including vulgaris, conglobata, and excoriée.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L70.0 | Acne vulgaris | Use when documenting typical acne lesions such as comedones and pustules. |
|
| L70.1 | Acne conglobata | Use for severe acne with nodules and cysts. |
|
| L70.5 | Acné excoriée | Use when acne lesions are excoriated due to picking. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acne vulgaris
Essential facts and insights about Acne
Primary ICD-10-CM Codes for acne
Decision Criteria
clinical Criteria
- Presence of comedones and inflammatory lesions
Applicable To
- Common acne
Excludes
- Acne rosacea (L71.-)
Clinical Validation Requirements
- Presence of comedones, papules, pustules
- Documented distribution on face, chest, or back
Code-Specific Risks
- Misclassification with rosacea
Coding Notes
- Ensure documentation specifies lesion types and distribution.
L70.1 - Acne conglobata
Use for severe acne with nodules and cysts.
Applicable To
- Severe nodulocystic acne
Clinical Validation Requirements
- Interconnected nodules and cysts
- Presence of sinus tracts and scarring
Coding Notes
Document severity and presence of sinus tracts.
L70.5 - Acné excoriée
Use when acne lesions are excoriated due to picking.
Applicable To
- Acne with excoriation
Clinical Validation Requirements
- Evidence of skin picking
- Associated with anxiety or compulsive behavior
Coding Notes
Ensure behavioral aspects are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Generalized anxiety disorder
F41.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acne to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L70.0.
Impact
Clinical: Impacts treatment decisions and follow-up care., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Use checklists to ensure all documentation elements are covered., Regular training on documentation standards.
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies lesion types to use specific codes like L70.0 or L70.1.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure documentation supports specific code selection.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acne, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acne
Use these documentation templates to ensure complete and accurate documentation for Acne. These templates include all required elements for proper coding and billing.
Moderate acne vulgaris
Specialty: DermatologyRequired Elements
- Lesion types
- Distribution
- Severity
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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