ICD-10 Coding for Hypertrophic Scar(L91.0)
Complete ICD-10-CM coding and documentation guide for Hypertrophic Scar. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertrophic Scar
L91-L99Primary Range
Other disorders of skin and subcutaneous tissue
This range includes hypertrophic scars and other skin disorders, with L91.0 specifically for hypertrophic scars.
Key Information: ICD-10 code for hypertrophic scar
Essential facts and insights about Hypertrophic Scar
Primary ICD-10-CM Code for hypertrophic scar
Decision Criteria
clinical Criteria
- Presence of raised, erythematous, firm scar with excessive collagen deposition.
coding Criteria
- Use L91.0 for hypertrophic scars, including keloids, not for acne-related keloids.
documentation Criteria
- Document size, location, symptoms, and functional limitations.
Clinical Validation Requirements
- Raised, erythematous, firm scar with excessive collagen deposition
- Confined to injury site (hypertrophic) or extends beyond original wound margins (keloid)
Code-Specific Risks
- Incorrectly coding as L90.5 for a symptomatic hypertrophic scar.
Coding Notes
- Ensure documentation specifies 'hypertrophic scar' or 'keloid' to avoid defaulting to L90.5.
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 Hypertrophic Scar to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L91.0.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Increases risk of audit findings., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific terms like 'hypertrophic' or 'keloid.', Include detailed descriptions in clinical notes.
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: May result in compliance issues during audits., Data Quality: Affects accuracy of clinical data and patient records.
Mitigation Strategy
Use L91.0 if 'raised,' 'pruritic,' or 'painful' is documented.
Impact
Using L90.5 instead of L91.0 for raised, symptomatic scars.
Mitigation Strategy
Educate providers on the importance of specific documentation.
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 Hypertrophic Scar, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertrophic Scar
Use these documentation templates to ensure complete and accurate documentation for Hypertrophic Scar. These templates include all required elements for proper coding and billing.
Hypertrophic Scar Evaluation
Specialty: DermatologyRequired Elements
- Location
- Size
- Texture
- Symptoms
- Treatment History
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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