ICD-10 Coding for Porokeratosis(L56.5, L85.2, D49.2)
Complete ICD-10-CM coding and documentation guide for Porokeratosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Porokeratosis
L56.5Primary Range
Disseminated Superficial Actinic Porokeratosis
Primary code for actinic variants of porokeratosis, confirmed by histopathology.
Other epidermal thickening
Includes keratosis punctata palmaris et plantaris, relevant for non-actinic porokeratosis.
Neoplasm of uncertain behavior of skin
Used when porokeratosis shows potential for malignant transformation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L56.5 | Disseminated Superficial Actinic Porokeratosis | Use for confirmed DSAP cases with histopathological evidence. |
|
| L85.2 | Keratosis punctata (palmaris et plantaris) | Use for non-actinic porokeratosis affecting palms or soles. |
|
| D49.2 | Neoplasm of uncertain behavior of skin | Use when porokeratosis shows potential for malignancy. |
|
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 porokeratosis
Essential facts and insights about Porokeratosis
Primary ICD-10-CM Codes for porokeratosis
Decision Criteria
clinical Criteria
- Presence of cornoid lamella on biopsy
documentation Criteria
- Lesions described as annular with hyperkeratotic borders
Applicable To
- Actinic porokeratosis
Excludes
- Actinic keratosis (L57.0)
Clinical Validation Requirements
- Histopathology confirming cornoid lamella
- Lesions on sun-exposed areas
Code-Specific Risks
- Misclassification with actinic keratosis
Coding Notes
- Ensure biopsy confirms cornoid lamella for accurate coding.
L85.2 - Keratosis punctata (palmaris et plantaris)
Use for non-actinic porokeratosis affecting palms or soles.
Applicable To
- Punctate porokeratosis
Excludes
- Actinic porokeratosis (L56.5)
Clinical Validation Requirements
- Presence of punctate hyperkeratotic lesions on palms or soles
Coding Notes
Document specific location and characteristics of lesions.
D49.2 - Neoplasm of uncertain behavior of skin
Use when porokeratosis shows potential for malignancy.
Applicable To
- Porokeratosis with atypical features
Clinical Validation Requirements
- Histopathology showing atypical cells or mitotic figures
Coding Notes
Ensure biopsy confirms atypical features before using.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic)
Z77.22Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Porokeratosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L56.5.
Impact
Clinical: Inadequate clinical documentation., Regulatory: Potential non-compliance with coding standards., Financial: Risk of claim denials.
Mitigation Strategy
Ensure detailed lesion descriptions are included in notes., Verify biopsy results are documented if performed.
Impact
Reimbursement: Claims may be denied if incorrect code is used., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure cornoid lamella is confirmed before coding as DSAP.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Potential audit issues., Data Quality: Misleading clinical data.
Mitigation Strategy
Document specific lesion characteristics and confirm with histopathology if needed.
Impact
Coding lesions without confirming type can lead to audits.
Mitigation Strategy
Ensure biopsy confirmation and detailed 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 Porokeratosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Porokeratosis
Use these documentation templates to ensure complete and accurate documentation for Porokeratosis. These templates include all required elements for proper coding and billing.
DSAP on sun-exposed areas
Specialty: DermatologyRequired Elements
- Lesion description
- Biopsy results
- UV exposure history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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