ED Coding and Reimbursement Alert

Question: We had a patient present with a rash for evaluation, and it turned out to be poison ivy. We thought this would be a straightforward diagnosis code but we’re unsure of what to report. Can you advise?

Codify Subscriber

Answer: You are correct in suggesting that coding poison ivy is a little more complicated than you think. First, there are as many as three ICD-10-CM codes that you could use: in addition to L23.7 (Allergic contact dermatitis due to plants, except food) and L24.7 (Irritant contact dermatitis due to plants, except food), there is also L25.5 (Unspecified contact dermatitis due to plants, except food). Therefore, you must first assess the origin of the poison ivy before selecting the most accurate diagnosis code.

Knowing the language of the descriptors will help you narrow down the diagnosis. L24.7 uses the word “irritant,” which means the dermatitis is localized, whereas L23.7 describes the condition as “allergic,” which is an indication that the poison ivy has spread and is now causing significant issues, such as infections on the skin.

If this is the case, coders should use as many diagnoses as possible if there are infections noted to help justify the level of care billed.