2025 ICD-10-CM code L56.0
Drug phototoxic response. Use additional code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5).
Medical necessity is established by the presence of a skin reaction consistent with a phototoxic response in a patient exposed to UV radiation while using a photosensitizing medication.
Clinicians should document the specific drug suspected of causing the phototoxic reaction, the type of UV radiation exposure (e.g., sunlight, tanning bed), and the characteristics of the skin reaction.If a specific drug can be identified, coding for the adverse effect of that drug is also recommended.
In simple words: A skin reaction caused by a combination of certain drugs and exposure to sunlight or other ultraviolet (UV) light sources.The drug makes the skin more sensitive to light, leading to symptoms similar to sunburn or other skin irritations.
Drug phototoxic response. Use additional code to identify the source of the ultraviolet radiation (W89, X32).
Example 1: A patient taking tetracycline develops a severe sunburn-like reaction after spending a short time in the sun. The diagnosis is drug phototoxic response (L56.0) due to tetracycline. An additional code for the adverse effect of the tetracycline should also be used., A patient undergoing PUVA (psoralen + UVA) therapy for psoriasis develops an exaggerated sunburn reaction. This is coded as L56.0, with an additional code for the adverse effect of psoralen, and a code from category W89 to specify UV radiation from an artificial source., A patient using a topical retinoid develops redness and scaling on their face after sun exposure. This would be coded as L56.0 due to retinoid, along with a code from category W89 for sunlight.
Documentation should include the clinical presentation of the skin reaction, the specific drug(s) implicated, the source of UV radiation exposure, and any associated symptoms.
- Specialties:Dermatology, Internal Medicine, Family Medicine, Allergy/Immunology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital,Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home