Is L12.31 a billable ICD-10-CM code?

Yes. L12.31 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does L12.31 sit in the tabular list?

Diseases of the skin and subcutaneous tissue (L00-L99), in the block Bullous disorders (L10-L14).

L12.31

L12.31 — Epidermolysis bullosa due to drug

Billable / specific codeICD-10-CM

L12.31 is a billable, specific ICD-10-CM code for epidermolysis bullosa due to drug. It is valid for submission on a claim.

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Risk adjustment

L12.31 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

L12.31 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57161Billing and Coding: Benign Skin Lesion Removal (Excludes Actinic Keratosis, and Mohs)
A57554Billing and Coding: Immune Globulins

How L12.31 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 L12.31.

Epidermolysis›bullosa›acquired›drug-induced

Related codes at this level

Codes that share L12.3. If L12.31 is not quite right, the correct code is usually one of these.

Questions about L12.31

Is L12.31 a billable ICD-10-CM code?: Yes. L12.31 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does L12.31 sit in the tabular list?: Diseases of the skin and subcutaneous tissue (L00-L99), in the block Bullous disorders (L10-L14).