ICD-10 Coding for Prurigo Nodularis(L28.1, L28.2)
Complete ICD-10-CM coding and documentation guide for Prurigo Nodularis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Prurigo Nodularis
L28-L29Primary Range
Other Dermatitis and Eczema
This range includes prurigo nodularis and related pruritic conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L28.1 | Prurigo Nodularis | Use when prurigo nodularis is confirmed with nodular lesions and chronic pruritus. |
|
| L28.2 | Other Prurigo | Use for prurigo subtypes excluding nodularis. |
|
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 prurigo nodularis
Essential facts and insights about Prurigo Nodularis
Primary ICD-10-CM Codes for prurigo nodularis
Decision Criteria
clinical Criteria
- Presence of firm nodular lesions with chronic pruritus.
documentation Criteria
- Document ≥20 nodules and pruritus duration.
Applicable To
- Chronic nodular prurigo
Excludes
- Other prurigo (L28.2)
Clinical Validation Requirements
- Presence of ≥20 nodules
- Pruritus duration ≥6 weeks
- Lichenification and excoriations
Code-Specific Risks
- Misclassification with L28.2 or L29 codes
Coding Notes
- Ensure documentation specifies nodular lesions to avoid misclassification.
L28.2 - Other Prurigo
Use for prurigo subtypes excluding nodularis.
Applicable To
- Papular prurigo
Excludes
- Prurigo nodularis (L28.1)
Clinical Validation Requirements
- Presence of pruritic papules without nodules
Coding Notes
Ensure differentiation from nodular prurigo.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other Pruritus
L29.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Prurigo Nodularis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L28.1.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use templates with required fields, Regular documentation audits
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify lesion type and use L28.1 for nodular presentations.
Impact
Inaccurate lesion count documentation.
Mitigation Strategy
Implement regular training and audits.
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 Prurigo Nodularis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Prurigo Nodularis
Use these documentation templates to ensure complete and accurate documentation for Prurigo Nodularis. These templates include all required elements for proper coding and billing.
Chronic prurigo nodularis with severe itching
Specialty: DermatologyRequired Elements
- Lesion description
- Pruritus duration
- Treatment response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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