2025 ICD-10-CM code L49.8
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the skin and subcutaneous tissue - Urticaria and erythema Diseases of the skin and subcutaneous tissue (L00-L99) Feed
Exfoliation due to an erythematous condition affecting 80-89% of the body surface.
The medical necessity for coding L49.8 is dependent on the underlying erythematous condition causing the exfoliation.The documentation should clearly establish the diagnosis of the underlying condition and the extent of the exfoliation.The severity of the condition and the need for treatment, such as hospitalization or specialized care, should also be documented to support medical necessity.
Diagnosis and management of the underlying erythematous condition and the exfoliative skin condition. This often involves a thorough skin examination, allergy testing if needed, laboratory tests to identify the causative organism (if infectious), and treatment depending on the underlying cause (e.g., antibiotics, supportive care, and medications to reduce inflammation).
In simple words: This code describes a serious skin condition where a large portion (80-89%) of the body's skin peels off due to redness and inflammation.The doctor will need to identify the specific cause of this peeling skin before billing this code.
This code classifies exfoliation (shedding of skin) resulting from an erythematous (reddened) condition that involves 80-89% of the body's surface area.It's crucial to code the underlying erythematous condition first. Examples include Ritter's disease (Staphylococcal scalded skin syndrome), Stevens-Johnson syndrome, Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome, and toxic epidermal necrolysis.
Example 1: A 2-year-old child presents with widespread blistering and skin peeling (85% body surface area) due to Staphylococcal scalded skin syndrome.L00 would be coded first, followed by L49.8., An adult patient develops severe skin reactions (80% body surface area) following a new medication, characterized by extensive redness, blistering, and peeling.The underlying drug reaction needs to be coded first, and L49.8 would be used to reflect the extent of the exfoliation. , A patient with a history of autoimmune disease presents with extensive exfoliation (88% body surface area) related to toxic epidermal necrolysis.The primary diagnosis of toxic epidermal necrolysis (L51.2) is coded first, with L49.8 secondary to indicate the extent of the exfoliation.
Complete history and physical examination; detailed description of the skin lesions, including location, size, and distribution; photographs of the affected areas; laboratory results (e.g., cultures, blood tests) to confirm the diagnosis of the underlying condition; and documentation of treatment provided.The percentage of body surface area affected needs to be documented.
** This code is used to specify the extent of exfoliation when it is associated with an underlying erythematous condition.The percentage of body surface area affected should be documented and carefully assessed. This is a severe skin condition and requires appropriate documentation to support billing.
- Payment Status: Active
- Specialties:Dermatology, Pediatrics, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Physician's Office