ICD-10 Coding for Erythema Multiforme(L51.9, L51.0, L51.1)
Complete ICD-10-CM coding and documentation guide for Erythema Multiforme. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Erythema Multiforme
L51Primary Range
Erythema Multiforme
This range includes all forms of erythema multiforme, including unspecified, nonbullous, and Stevens-Johnson syndrome.
Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
Used to code adverse effects of drugs that may cause erythema multiforme.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L51.9 | Erythema multiforme, unspecified | Use when erythema multiforme is diagnosed but not further specified. |
|
| L51.0 | Nonbullous erythema multiforme | Use for erythema multiforme with classic target lesions and no blisters. |
|
| L51.1 | Stevens-Johnson syndrome | Use when erythema multiforme involves mucosal surfaces and less than 10% epidermal detachment. |
|
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 erythema multiforme
Essential facts and insights about Erythema Multiforme
Primary ICD-10-CM Codes for erythema multiforme
Decision Criteria
clinical Criteria
- Target lesions without mucosal involvement
Applicable To
- Erythema multiforme minor
Clinical Validation Requirements
- Presence of target lesions
- No mucosal involvement
Code-Specific Risks
- Risk of undercoding if mucosal involvement is present.
Coding Notes
- Ensure documentation specifies the presence or absence of mucosal involvement.
L51.0 - Nonbullous erythema multiforme
Use for erythema multiforme with classic target lesions and no blisters.
Applicable To
- Erythema multiforme minor
Excludes
- Stevens-Johnson syndrome (L51.1)
Clinical Validation Requirements
- Classic target lesions
- No blisters
Coding Notes
Ensure documentation specifies the absence of blisters.
L51.1 - Stevens-Johnson syndrome
Use when erythema multiforme involves mucosal surfaces and less than 10% epidermal detachment.
Applicable To
- Erythema multiforme major
Excludes
- Toxic epidermal necrolysis (L51.2)
Clinical Validation Requirements
- Mucosal involvement
- Less than 10% epidermal detachment
Coding Notes
Ensure documentation specifies mucosal involvement and percentage of epidermal detachment.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Adverse effect of drugs
T36-T50Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Erythema Multiforme to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L51.9.
Impact
Clinical: Leads to misclassification of severity., Regulatory: Potential audit flags for incorrect coding., Financial: May affect reimbursement rates.
Mitigation Strategy
Verify mucosal involvement before coding., Use specific codes for major forms.
Impact
Reimbursement: Incorrect coding can lead to inappropriate DRG assignment., Compliance: May result in compliance issues during audits., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Differentiate based on mucosal involvement and percentage of epidermal detachment.
Impact
Failure to sequence drug reaction codes first can lead to audit findings.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Erythema Multiforme, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Erythema Multiforme
Use these documentation templates to ensure complete and accurate documentation for Erythema Multiforme. These templates include all required elements for proper coding and billing.
New Onset Erythema Multiforme
Specialty: DermatologyRequired Elements
- Lesion description
- Mucosal involvement
- Drug history
- Biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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