L12.0
L12.0: Bullous pemphigoid
Billable / specific codeICD-10-CM
L12.0 is a billable, specific ICD-10-CM code for bullous pemphigoid. It is valid for submission on a claim.
Check L12.0 with the rest of the claim: free scrubberOther codes that can never be billed with L12.0
Their own Excludes1 notes name this code, so the conflict is not listed above.
- 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
L12.0 is named in 13 Medicare coverage policies: 13 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
- Pemphigoid›bullous
- Dermatitis›herpetiformis›senile
- Erythema, erythematous›multiforme›pemphigoides
- Herpes, herpesvirus, herpetic›circinatus›bullosus
Code history
Unchanged in every release from FY2024 to FY2027.