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ICD-10 Coding for Sunburn(L55.0, L55.1, L55.2, L55.9, L56.8)

Complete ICD-10-CM coding and documentation guide for Sunburn. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Solar erythemaUV burn

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Related ICD-10 Code Ranges

Complete code families applicable to Sunburn

L55Primary Range

Sunburn

This range covers all degrees of sunburn, from first to third degree, and unspecified cases.

L56

Other acute skin changes due to ultraviolet radiation

Includes sunburn from artificial sources like tanning beds.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
L55.0Sunburn of first degreeUse for erythema caused by sun exposure without blistering.
  • Tender erythema without blistering
L55.1Sunburn of second degreeUse for sunburns with blistering.
  • Clear fluid-filled blisters, moist surface
L55.2Sunburn of third degreeUse for severe sunburns with necrosis.
  • Dry, leathery skin with white/black discoloration
L55.9Sunburn, unspecifiedUse when the degree of sunburn is not documented.
  • General symptoms of sunburn without specific degree
L56.8Other specified acute skin changes due to ultraviolet radiationUse for sunburns from tanning beds or other artificial UV sources.
  • Skin changes due to artificial UV exposure

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 sunburn

Essential facts and insights about Sunburn

The ICD-10 code for sunburn varies by degree: L55.0 for first degree, L55.1 for second degree, L55.2 for third degree, and L55.9 for unspecified sunburn.

Primary ICD-10-CM Codes for sunburn

L55.0
Sunburn of first degree
Billable Code

Decision Criteria

clinical Criteria

  • Presence of erythema without blistering

Applicable To

  • Erythema without blistering

Excludes

Clinical Validation Requirements

  • Tender erythema without blistering

Code-Specific Risks

  • Misclassification as a thermal burn

Coding Notes

  • Ensure documentation specifies sun exposure as the cause.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Exposure to tanning bed

W89.1XXA
Use with L56.8 for burns from tanning beds.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Burn of first degree of head and neck

T20.0
Use T20.0 for thermal burns, not sunburns.

Burn of second degree of trunk

T21.2
Use T21.2 for thermal burns, not sunburns.

Burn of third degree of upper limb

T22.3
Use T22.3 for thermal burns, not sunburns.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Sunburn to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L55.0.

Impact

Clinical: May lead to inappropriate treatment recommendations., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.

Mitigation Strategy

Use structured templates, Educate staff on documentation standards

Impact

Reimbursement: Incorrect DRG assignment leading to potential denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate data on burn types.

Mitigation Strategy

Always use L55.x codes for sunburns.

Impact

Reimbursement: May affect billing accuracy and reimbursement., Compliance: Failure to meet documentation standards., Data Quality: Lack of specificity in patient records.

Mitigation Strategy

Ensure documentation includes the degree of burn.

Impact

Using thermal burn codes instead of L55 series.

Mitigation Strategy

Regular training and audits of coding practices.

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 Sunburn, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Sunburn

Use these documentation templates to ensure complete and accurate documentation for Sunburn. These templates include all required elements for proper coding and billing.

Second-degree sunburn from outdoor exposure

Specialty: Dermatology

Required Elements

  • Degree of burn
  • Body site and laterality
  • Source of UV exposure
  • Symptoms

Example Documentation

Patient presents with painful erythema and multiple blisters on the anterior trunk and bilateral upper arms, covering approximately 15% TBSA, consistent with second-degree sunburn from prolonged outdoor exposure.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has sunburn.
Good Documentation Example
Erythema and vesicles covering 8% BSA on bilateral shoulders, consistent with second-degree sunburn from prolonged outdoor exposure.
Explanation
The good example provides specific details on the degree, location, and cause of the sunburn.

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