L12.0 — Bullous pemphigoid
L12.0 is a billable, specific ICD-10-CM code for bullous pemphigoid. It is valid for submission on a claim.
Other codes that can never be billed with L12.0
These codes carry an Excludes1 note pointing at L12.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading L12.0 alone.
- L13.0Dermatitis herpetiformis
Risk adjustment
L12.0 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
L12.0 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
- A55639Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
How L12.0 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 L12.0.
- Pemphigoid›bullous
- Dermatitis›herpetiformis›senile
- Erythema, erythematous›multiforme›pemphigoides
- Herpes, herpesvirus, herpetic›circinatus›bullosus
Related codes at this level
Codes that share L12. If L12.0 is not quite right, the correct code is usually one of these.
Questions about L12.0
- Is L12.0 a billable ICD-10-CM code?
- Yes. L12.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L12.0 sit in the tabular list?
- Diseases of the skin and subcutaneous tissue (L00-L99), in the block Bullous disorders (L10-L14).