Is ICD-10-CM code L05 billable?

No, L05 (Pilonidal cyst and sinus) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code L05 belong to?

L05 belongs to Chapter 12 of the ICD-10-CM tabular list: L00–L99 (Diseases of the Skin and Subcutaneous Tissue).

L05Not billable, use a more specific code below

Pilonidal cyst and sinus

In Infections of the skin and subcutaneous tissue (L00-L08), chapter 12: Diseases of the Skin and Subcutaneous Tissue

4 billable codes under L05: 2 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Also applies, from Infections of the skin and subcutaneous tissue (L00-L08)

These notes sit on L00-L08 and apply to every code under it, including L05.

Excludes2: not included here, code separately if applicable

hordeolum (H00.0)
infective dermatitis (L30.3)
local infections of skin classified in Chapter 1
lupus panniculitis (L93.2)
panniculitis NOS (M79.3)
panniculitis of neck and back (M54.0-)
Perlèche NOS (K13.0)
Perlèche due to candidiasis (B37.0)
Perlèche due to riboflavin deficiency (E53.0)
pyogenic granuloma (L98.0)
relapsing panniculitis [Weber-Christian] (M35.6)
viral warts (B07.-)
zoster (B02.-)

Use additional code: add a second code for this, listed after this one

code (B95-B97) to identify infectious agent.

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers assigning pressure ulcer codes by site and stage, including unstageable, healing, healed, and progressing ulcers, and coding healing or progressing non-pressure chronic ulcers.

Pressure ulcer stage codes (page 58)
Non-Pressure Chronic Ulcers (page 60)

Read Section I.C.12 (page 58)

All codes under L05

L05 can't be used on a claim. Pick a billable code below; grey headings group them.

L05 MS-DRGs

As the principal diagnosis, all 4 billable codes under L05 group to MS-DRG 602 or 603 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to L05

Notes on these codes point to L05.

Q43.6 Excludes1: pilonidal fistula or sinus (L05.-)
Q82 Excludes1: pilonidal cyst or sinus (L05.-)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Tailbone Disorders

The tailbone is the small bone at the bottom of your backbone, or spine. Tailbone disorders include tailbone injuries, pain, infections, cysts and tumors. You rarely break your tailbone. Instead, most injuries cause bruises or pulled ligaments. A backward fall onto a hard surface, such as slipping on ice, is the most common cause of such injuries. Symptoms of various tailbone disorders include pain in the tailbone area, pain upon sitting, pain or numbness in the arms or legs due to pressure on nerves in the tailbone area, and a mass or growth you can see or feel.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.