Facebook tracking pixelAcne Scarring - AI-Powered ICD-10 Documentation
L90.5
ICD-10-CM
Acne Scarring

Understanding acne scarring, also known as post-acne scarring or acne scars, is crucial for accurate clinical documentation and medical coding. This resource provides information on atrophic acne scars and other types of acne scarring, focusing on healthcare best practices for diagnosis and treatment. Learn about the different types of acne scars and explore effective management strategies used in modern dermatology. Find resources relevant to acne scar treatment, including information on coding and documentation for healthcare professionals.

Also known as

Post-Acne Scarring
Acne Scar
Atrophic Acne Scars

Diagnosis Snapshot

Key Facts
  • Definition : Permanent textural changes to the skin resulting from acne inflammation.
  • Clinical Signs : Indented, rolling, boxcar, or ice-pick scars. Skin discoloration and uneven texture.
  • Common Settings : Dermatology clinics, medical spas, plastic surgery offices.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC L90.5 Coding
L70-L75

Diseases of the skin and subcutaneous tissue

Includes various skin conditions like acne and scarring.

L90-L99

Other disorders of the skin and subcutaneous tissue

Encompasses other skin disorders, potentially including scar-related issues.

Z87.0

Personal history of diseases of the skin and subcutaneous tissue

Codes for past skin diseases, which could include acne scarring history.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the scarring due to acne vulgaris?

  • Yes

    Is the scarring keloid or hypertrophic?

  • No

    What is the cause of the scarring?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Depressed or raised scars from acne.
Enlarged, raised scars beyond initial injury.
Excessive scar tissue growth, raised and firm.

Documentation Best Practices

Documentation Checklist
  • Document scar type (atrophic, hypertrophic, keloid)
  • Specify scar location and size (mm)
  • Note scar morphology (ice pick, boxcar, rolling)
  • Record any associated symptoms (pain, itching)
  • Assess pigmentation changes (hyperpigmentation, hypopigmentation)

Coding and Audit Risks

Common Risks
  • Unspecified Scar Type

    Coding acne scarring without specifying the type (e.g., atrophic, hypertrophic, keloid) can lead to rejected claims or inaccurate reimbursement.

  • Missing Severity Documentation

    Lack of documentation specifying the severity (mild, moderate, severe) of acne scarring may impact medical necessity reviews and coding accuracy.

  • Conflicting Terminology

    Using varying terms like "post-acne scarring" or "acne scar" without clear linkage to "acne scarring" can create coding inconsistencies and audit issues.

Mitigation Tips

Best Practices
  • Minimize scarring: Early acne treatment.
  • ICD-10: L90.5; Document scar type, morphology.
  • Reduce inflammation: Avoid picking, squeezing.
  • Topical retinoids, chemical peels: Improve texture.
  • Fractional lasers, microneedling: Consult dermatologist.

Clinical Decision Support

Checklist
  • Confirm acne scar type (ice pick, boxcar, rolling) matches documentation and ICD-10 (L70.0).
  • Verify scar location and size are clearly documented for accurate coding and treatment.
  • Assess for psychological impact of scarring and document patient reported outcomes (PROs).
  • Review prior treatments and their effectiveness for informed decision-making.

Reimbursement and Quality Metrics

Impact Summary
  • ICD-10-CM code L90.5 (Acne scarring) impacts reimbursement through accurate coding for medical billing and claims processing.
  • Accurate acne scar diagnosis coding (L90.5) improves hospital reporting quality metrics for skin condition management.
  • Proper coding of acne scarring (L90.5 and related codes) ensures appropriate reimbursement and reflects resource utilization.
  • Coding accuracy for acne scarring impacts quality metrics related to dermatological procedures and patient outcomes.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective treatment strategies for differentiating and managing atrophic acne scars in Fitzpatrick skin types IV-VI?

A: Atrophic acne scars, including ice pick, boxcar, and rolling scars, present unique challenges in Fitzpatrick skin types IV-VI due to the increased risk of post-inflammatory hyperpigmentation (PIH). Effective management requires a tailored approach considering both scar subtype and skin tone. For ice pick scars, TCA CROSS, punch excision, or radiofrequency microneedling can be effective. Boxcar scars often respond well to subcision, fillers, or laser resurfacing. Rolling scars may benefit from subcision combined with fillers or laser treatments. When treating skin of color, it's crucial to use lower energy settings for lasers and chemical peels to minimize PIH risk. Prioritizing treatments that stimulate collagen remodeling, such as microneedling with radiofrequency, may also be beneficial. Explore how combination therapies can enhance outcomes and consider implementing preventative measures like early acne treatment to minimize scarring risk in these skin types. Learn more about managing PIH with topical agents like hydroquinone, retinoids, and corticosteroids after procedural treatments.

Q: How can I accurately assess and classify different acne scar types to determine the optimal treatment approach for my patients?

A: Accurate acne scar classification is fundamental for selecting the most effective treatment strategy. Begin by visually inspecting the scars under good lighting, possibly with magnification. Atrophic scars are categorized as ice pick, boxcar, or rolling based on their morphology. Ice pick scars are narrow, deep, and sharply defined. Boxcar scars are wider, with well-defined vertical edges, resembling a 'boxcar.' Rolling scars are broader, shallower depressions with sloping edges that give the skin a wave-like appearance. Hypertrophic scars, conversely, are raised and firm due to excess collagen. Keloid scars extend beyond the original wound boundaries. Proper assessment involves not only identifying the scar type but also considering skin type, patient preferences, and potential complications. Consider implementing standardized photographic documentation to track treatment progress. Explore how dermatoscopy can aid in detailed scar assessment and differentiation.

Quick Tips

Practical Coding Tips
  • Code scarring type: icepick, boxcar, rolling
  • Document scar morphology, location, severity
  • Consider L90.5, L70.0, L72.0
  • Check payer guidelines for acne scarring
  • Pair with active acne codes if present

Documentation Templates

Patient presents with acne scarring, consistent with post-acne scarring, characterized by atrophic acne scars on the [location - e.g., face, back, chest].  The patient reports a history of acne vulgaris, with onset at [age of onset].  The scarring presents as [scar type - e.g., ice pick, boxcar, rolling] and is [severity - e.g., mild, moderate, severe] in appearance.  Skin examination reveals [detailed description of scar characteristics - e.g.,  dyspigmentation, textural changes,  indentation].  Differential diagnoses considered include other types of scarring, such as varicella scarring and traumatic scarring.  The patient's Fitzpatrick skin type is [skin type].  Current treatment plan includes [treatment options - e.g., topical retinoids, chemical peels, microneedling, laser resurfacing, dermal fillers] to address the atrophic scarring and improve skin texture and appearance.  Patient education provided on scar management, sun protection, and realistic expectations for treatment outcomes.  Follow-up scheduled in [duration - e.g., 4 weeks] to assess treatment response and adjust the plan as needed.  ICD-10 code L70.0 (Acne keloid) or L90.5 (Scar conditions and fibrosis of skin) may be considered depending on the specific scar type.  CPT codes for procedures performed, such as microneedling or laser resurfacing, will be documented separately.