Is ICD-10-CM code L12 billable?

No, L12 (Pemphigoid) 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 L12 belong to?

L12 belongs to Chapter 12 of the ICD-10-CM tabular list: L00–L99 (Diseases of the Skin and Subcutaneous Tissue).

L12Not billable, use a more specific code below

Pemphigoid

In Bullous disorders (L10-L14), chapter 12: Diseases of the Skin and Subcutaneous Tissue

8 billable codes under L12: 6 are a CC; 4 map to HCC 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

herpes gestationis (O26.4-)
impetigo herpetiformis (L40.1)

Also applies, from Bullous disorders (L10-L14)

These notes sit on L10-L14 and apply to every code under it, including L12.

Excludes1: not coded here, use a different code

benign familial pemphigus [Hailey-Hailey] (Q82.8)
staphylococcal scalded skin syndrome (L00)
toxic epidermal necrolysis [Lyell] (L51.2)

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 L12

L12 can't be used on a claim. Pick a billable code below; grey headings group them.

L12 MS-DRGs

As the principal diagnosis, the billable codes under L12 group to MS-DRG 595, 596, 606, or 607 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 595 Major Skin Disorders with MCC (7 of 8 codes)
DRG 596 Major Skin Disorders without MCC (7 of 8 codes)
DRG 606 Minor Skin Disorders with MCC (1 of 8 codes)
DRG 607 Minor Skin Disorders without MCC (1 of 8 codes)

About the condition

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

Pemphigus

Pemphigus is an autoimmune disorder. If you have it, your immune system attacks healthy cells in your skin and mouth, causing blisters and sores. No one knows the cause. Pemphigus does not spread from person to person. It does not appear to be inherited. But some people's genes put them more at risk for pemphigus.

Code history

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