Is L56.4 a billable ICD-10-CM code?

Yes. L56.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does L56.4 sit in the tabular list?

Diseases of the skin and subcutaneous tissue (L00-L99), in the block Radiation-related disorders of the skin and subcutaneous tissue (L55-L59).

L56.4

L56.4 — Polymorphous light eruption

Billable / specific codeICD-10-CM

L56.4 is a billable, specific ICD-10-CM code for polymorphous light eruption. It is valid for submission on a claim.

Risk adjustment

L56.4 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

L56.4 is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56459Billing and Coding: Debridement Services
A57181Billing and Coding: Allergy Testing
A60360Billing and Coding: Allergy Diagnostic Testing
A60363Billing and Coding: Allergy Diagnostic Testing

How L56.4 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 L56.4.

Eruption›Hutchinson, summer
Eruption›polymorphous light(sun)
Hydroa›aestivale
Hydroa›vacciniforme
Prurigo›estivalis
Hutchinson's›disease, meaning›prurigo estivalis
Hutchinson's›disease, meaning›summer eruption or summer prurigo

Related codes at this level

Codes that share L56. If L56.4 is not quite right, the correct code is usually one of these.

Questions about L56.4

Is L56.4 a billable ICD-10-CM code?: Yes. L56.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does L56.4 sit in the tabular list?: Diseases of the skin and subcutaneous tissue (L00-L99), in the block Radiation-related disorders of the skin and subcutaneous tissue (L55-L59).