ICD-10 Coding for Chest Wall Abscess(L02.213, T85.73)
Complete ICD-10-CM coding and documentation guide for Chest Wall Abscess. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chest Wall Abscess
L00-L08Primary Range
Infections of the skin and subcutaneous tissue
This range includes codes for various skin infections, including abscesses.
Complications of surgical and medical care, not elsewhere classified
This range includes codes for complications related to medical devices or procedures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L02.213 | Cutaneous abscess of chest wall | Use for simple cutaneous abscess confined to the chest wall. |
|
| T85.73 | Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts | Use when the abscess is due to an infected device or implant. |
|
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 chest wall abscess
Essential facts and insights about Chest Wall Abscess
Primary ICD-10-CM Codes for chest wall abscess
Decision Criteria
clinical Criteria
- Presence of a fluctuant mass on the chest wall
documentation Criteria
- Imaging confirmation of fluid collection
Applicable To
- Abscess of pectoral region
- Cellulitis and abscess of chest wall
Clinical Validation Requirements
- Palpable fluctuance
- Imaging confirmation (CT/US showing fluid collection ≥1 cm)
- WBC >11,000/μL OR CRP >10 mg/L
Code-Specific Risks
- Confusing with breast abscess
- Using unspecified codes like L02.91
Coding Notes
- Ensure documentation specifies the location and depth of the abscess.
T85.73 - Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts
Use when the abscess is due to an infected device or implant.
Applicable To
- Infected mesh/device in chest wall
Clinical Validation Requirements
- Recurrent abscess at mesh implantation site
- Culture results indicating infection
Coding Notes
Sequence this code first if the abscess is device-related.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chest Wall Abscess to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L02.213.
Impact
Clinical: Inaccurate treatment decisions due to lack of organism identification., Regulatory: Non-compliance with coding guidelines requiring organism specification., Financial: Potential loss of MCC capture, affecting reimbursement.
Mitigation Strategy
Ensure culture results are documented in the patient's record., Use ancillary codes for identified organisms.
Impact
Reimbursement: May lead to denial of claims due to lack of specificity., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Require documentation specifying 'chest wall' anatomy.
Impact
High denial rates for unspecified abscess codes.
Mitigation Strategy
Require detailed documentation specifying the anatomical location.
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 Chest Wall Abscess, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chest Wall Abscess
Use these documentation templates to ensure complete and accurate documentation for Chest Wall Abscess. These templates include all required elements for proper coding and billing.
ED Progress Note for Chest Wall Abscess
Specialty: Emergency MedicineRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Culture results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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