Pityriasis rosea
In Papulosquamous disorders (L40-L45), chapter 12: Diseases of the Skin and Subcutaneous Tissue
- L42 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under L40-L45 below.
- As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as chronic: expected to last 12 months or longer and to limit daily life or need ongoing care.
Also indexed as: Disease, Gibert's; Disease, Hebra's, pityriasis, maculata et circinata; Gibert's disease or pityriasis; Pityriasis, circinata; Pityriasis, rosea
Advertisements
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)
Other codes under L40-L45
Papulosquamous disorders (L40-L45)
L42 MS-DRGs
As the principal diagnosis, L42 groups to MS-DRG 606 or 607 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
L42 is in Other specified inflammatory condition of skin (SKN002, its default category), with 164 codes. Others in it:
- B65.3 Cercarial dermatitis
- E08.620 Diabetes mellitus due to underlying condition with diabetic dermatitis
- E09.620 Drug or chemical induced diabetes mellitus with diabetic dermatitis
- E10.620 Type 1 diabetes mellitus with diabetic dermatitis
- E11.620 Type 2 diabetes mellitus with diabetic dermatitis
- E13.620 Other specified diabetes mellitus with diabetic dermatitis
- L10.0 Pemphigus vulgaris
- L10.1 Pemphigus vegetans
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Skin Conditions
Your skin is your body's largest organ. It covers the entire outside of your body. There are many ways that your skin protects your body and helps keep you healthy. For example, it:
Read more about skin conditions on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 696.3 Pityriasis rosea