2025 ICD-10-CM code L49
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Skin and subcutaneous tissue diseases - Urticaria and erythema (L49-L54) Diseases of the skin and subcutaneous tissue (L00-L99) Feed
Exfoliation due to erythematous conditions, categorized by body surface area involved.Always code the underlying erythematous condition first.
Modifiers may be applicable based on the specific circumstances and services provided. Consult the official modifier guidelines for specific applicability.
The medical necessity is established by the presence of the underlying erythematous condition causing significant skin exfoliation.This condition requires medical intervention to manage the associated discomfort, prevent infection, and promote wound healing.
Diagnosis and management of the underlying erythematous condition causing the exfoliation, along with treatment of the exfoliated skin to prevent infection and promote healing. This may involve dermatological examination, laboratory tests (e.g., cultures), and appropriate medication (e.g., antibiotics, corticosteroids).
- Diseases of the skin and subcutaneous tissue (L00-L99)
- L00-L99 (Diseases of the skin and subcutaneous tissue); L49-L54 (Urticaria and erythema)
In simple words: This code describes skin peeling caused by redness and inflammation.The doctor will also code the specific skin problem causing the peeling.This helps ensure accurate billing and treatment.
This ICD-10-CM code classifies exfoliation (shedding of skin) resulting from erythematous (reddened) skin conditions.The extent of body surface area affected determines the specific code within the L49 range (L49.0, L49.1, L49.2, L49.8, L49.9).Crucially, the underlying erythematous condition causing the exfoliation must be coded first.Examples of such conditions include Ritter's disease (L00), staphylococcal scalded skin syndrome (L00), Stevens-Johnson syndrome (L51.1), Stevens-Johnson syndrome/toxic epidermal necrolysis overlap syndrome (L51.3), and toxic epidermal necrolysis (L51.2).
Example 1: A 2-year-old child presents with widespread blistering and peeling skin (scalded skin syndrome) due to a staphylococcal infection.Codes L00 (Staphylococcal scalded skin syndrome) and L49.9 (Exfoliation due to erythematous condition, unspecified body surface area) are used., An adult patient experiences a severe reaction to medication, resulting in widespread skin blistering and peeling (toxic epidermal necrolysis). The physician would code L51.2 (Toxic epidermal necrolysis) and L49.8 (Exfoliation due to other specified erythematous conditions)., A patient develops Stevens-Johnson syndrome (SJS), exhibiting extensive skin peeling. The appropriate codes would be L51.1 (Stevens-Johnson syndrome) and one of the L49 codes based on the percentage of skin surface affected.
Detailed history of the presenting complaint, physical examination findings emphasizing the extent of skin exfoliation and erythema, laboratory test results (e.g., cultures to identify infectious agents), and details of any medication use or allergic reactions.Documentation must support the diagnosis of both the underlying erythematous condition and the degree of exfoliation.
** The codes within the L49 range are supplementary codes that describe the extent of exfoliation.The primary diagnosis (underlying erythematous condition) is paramount for accurate billing and treatment.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is a diagnostic code.
- Specialties:Dermatology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Urgent Care Facility