2025 ICD-10-CM code L72.0
(Active) Effective Date: N/A Revision Date: N/A Diseases of the skin and subcutaneous tissue - Disorders of skin appendages (L60-L75) Diseases of the skin and subcutaneous tissue (L00-L99) Feed
Epidermal cyst is a benign, fluid-filled sac under the skin.
Modifiers might be applicable depending on the circumstances of the service. For example, modifier -50 (bilateral procedure) could apply if cysts are present on both sides of the body. Modifiers -25 (significant, separately identifiable E/M service by the same physician on the same day) or -59 (distinct procedural service) might also apply.
Medical necessity for the management of an epidermal cyst is established when the cyst is symptomatic (causing pain, inflammation, or infection), or when it is large or cosmetically concerning.The intervention's necessity is based on the clinical judgment of the healthcare provider considering the patient's overall health, symptoms, and preferences. The documentation should clearly justify the chosen management plan, whether observation, ID, or surgical excision.
The clinical responsibility for an epidermal cyst would typically involve a dermatologist or general practitioner who assesses the lesion, makes a diagnosis, and determines the appropriate management plan, which might include observation, incision and drainage, or excision.
- Diseases of the skin and subcutaneous tissue (L00-L99)
- L72 (Follicular cysts of skin and subcutaneous tissue)
In simple words: An epidermal cyst is a small, harmless lump under the skin filled with a cheesy-like material. It's usually not painful unless it gets infected.
L72.0, Epidermal cyst, refers to a benign, encapsulated lesion in the skin or subcutaneous tissue.It is characterized by a saclike structure with a wall of stratified epithelium containing keratohyalin granules. The cyst's contents are typically composed of keratinous material.Epidermal cysts are commonly found on the face, scalp, and trunk. They can range in size from a few millimeters to several centimeters.
Example 1: A 35-year-old male presents with a slowly growing, painless lump on his scalp. Physical examination reveals a firm, rounded, subcutaneous mass, approximately 1cm in diameter, consistent with an epidermal cyst.The diagnosis is confirmed through clinical evaluation. No intervention is necessary at this time, but the patient is advised to monitor for any changes in size, pain, or inflammation., A 60-year-old female presents with an infected epidermal cyst on her cheek. The cyst is red, tender, swollen, and fluctuant.The physician performs an incision and drainage (ID) procedure, removing the purulent material and debris. The patient is prescribed antibiotics to prevent recurrence and further infection. , A 22-year-old female presents with a large, cosmetically concerning epidermal cyst on her face, causing discomfort and affecting her self-esteem. The physician decides that surgical excision is the best course of action. The cyst is surgically excised, and the specimen is sent for histopathological examination to confirm the diagnosis and rule out malignancy.
Complete medical history, physical examination findings including location, size, and appearance of the cyst, any associated symptoms (pain, inflammation, infection),diagnostic imaging if necessary (ultrasound), and pathology report if a biopsy or excision was performed are essential documentation requirements for accurate coding.Detailed descriptions of any procedures performed, such as ID or surgical excision, including the technique, anesthesia used, and any complications, must be documented.
** Always refer to the most current version of the ICD-10-CM coding manual for the most up-to-date guidelines and information.The decision to intervene on an epidermal cyst should be based on clinical judgment considering the patient's symptoms, size and location of the cyst, and potential risks and benefits of intervention.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this diagnosis code, as it is a diagnosis code and not a procedural code.
- Specialties:Dermatology, General Surgery, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center