# ICD-10 Actinic Keratosis Clarification



## douglaCD (Jul 21, 2015)

Hey All!

I'm a derm coding specialist in VA. 

Anywho, my question is RE: *L57.0* actinic keratosis; per the ICD 10 guidelines we are to use an additional code from category *X32* which will identify the source of radition. HOWEVER, actinic means "sun" and whats more perplexing is that the *X32 *code [_exposure to sunlight_] has an excludes 1 note that states:

"*Excludes1:
radiation-related disorders of the skin and subcutaneous tissue (L55-L59)"
*
 ...  Is my logic off or are the guidelines contradictory here? My suggestion to the derm providers was to avoid use of the additional code when using the L57.0 dx. What are your thoughts?


Thanks and take care, 

Christina D


----------



## mitchellde (Jul 21, 2015)

douglaCD said:


> Hey All!
> 
> I'm a derm coding specialist in VA.
> 
> ...


There are more than a few contradictory issues with ICD-10 CM.  the excludes 1 note will take priority though.  there is a form on the CDC website where you can communicate these issues back to the committee that makes the changes to the code set.


----------



## douglaCD (Jul 21, 2015)

Awesome, Debra! Thanks for your speedy reply. Happy to know that I am not alone 

Christina D


----------



## dmwaters54 (Sep 19, 2019)

I don't know if it has changed since this was posted in 2015 but X32 has an Excludes 2 note not an Excludes 1 note meaning it can be coded with L57.0.


----------



## mitchellde (Sep 20, 2019)

The ICD-10 committee recognized it had made several errors with respect to the excludes 1 notes and acknowledged that some were incorrectly labeled and should have been excludes 2 from the start. this was fixed then with the October updates of 2016-2019 and continues to be updated as they find errors.


----------

