L10.4
L10.4: Pemphigus erythematosus
Billable / specific codeICD-10-CM
L10.4 is a billable, specific ICD-10-CM code for pemphigus erythematosus. It is valid for submission on a claim.
Check L10.4 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Senear-Usher syndrome
Risk adjustment
L10.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 387 Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders0.406 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
L10.4 is named in 14 Medicare coverage policies: 14 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A54641Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
- A54643Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
- A55639Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
- A56380Billing and Coding: Rituximab
Alphabetic index entries that lead here
- Senear-Usher disease or syndrome
- Usher-Senear disease or syndrome
- Pemphigus›erythematosus
Code history
Unchanged in every release from FY2024 to FY2027.