2025 ICD-10-CM code L49.9
(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 90% or more of the body surface.
Medical necessity for L49.9 is established by documenting the presence of a significant erythematous condition and the extent of skin exfoliation (≥90% of body surface area).Treatment is deemed medically necessary to prevent infection, fluid loss, and complications associated with severe skin loss.
Diagnosis and treatment of the underlying erythematous condition causing the exfoliation, as well as management of the exfoliated skin to prevent infection and promote healing.
In simple words: This code is used when a person's skin is severely red and peeling off in large areas (90% or more of their body). The doctor will need to determine what caused this problem first before applying this code.
This code classifies exfoliation (shedding of skin) resulting from an erythematous (reddened) condition that involves 90% or more of the body's surface area.It's crucial to code the underlying erythematous condition first. Examples of such conditions 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 presents with widespread blistering and skin peeling (95% body surface area) consistent with Staphylococcal scalded skin syndrome.L00 and L49.9 are coded., A 30-year-old patient develops extensive skin detachment and erythema after taking a new medication, meeting criteria for toxic epidermal necrolysis. L51.2 and L49.9 would be coded., A 45-year-old patient presents with symptoms of Stevens-Johnson syndrome (SJS) and extensive skin sloughing involving 90% of the body.L51.1 and L49.9 are reported.
Detailed history and physical examination findings, including extent of skin involvement, description of skin lesions (erythema, blistering, peeling), laboratory test results (e.g., cultures for bacterial infection), imaging studies if indicated, and documentation of the underlying cause.
** This code is for severe cases of exfoliation.Appropriate supportive care and management of complications should be documented.
- Payment Status: Active
- Specialties:Dermatology, Pediatrics, Internal Medicine, Critical Care
- Place of Service:Inpatient Hospital, Emergency Room - Hospital