L10.4 — Pemphigus erythematosus
L10.4 is a billable, specific ICD-10-CM code for pemphigus erythematosus. It is valid for submission on a claim.
Inclusion 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.
Medicare coverage
L10.4 is named in 17 Medicare coverage policies — 17 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How L10.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to L10.4.
- Senear-Usher disease or syndrome
- Usher-Senear disease or syndrome
- Pemphigus›erythematosus
Related codes at this level
Codes that share L10. If L10.4 is not quite right, the correct code is usually one of these.
Questions about L10.4
- Is L10.4 a billable ICD-10-CM code?
- Yes. L10.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L10.4 sit in the tabular list?
- Diseases of the skin and subcutaneous tissue (L00-L99), in the block Bullous disorders (L10-L14).