Lichen sclerosus is a chronic inflammatory skin condition that can cause discomfort and affect quality of life. In medical coding and diagnosis, the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) provides a standardized system. For lichen sclerosus et atrophicus, the specific diagnosis code is L90.0. This code is essential for accurate medical billing, record-keeping, and epidemiological tracking.
ICD-10-CM Code L90.0: Key Information
Code L90.0 is designated as a billable/specific ICD-10-CM code. This means it is a valid code for submitting claims for reimbursement for medical services provided on or after October 1, 2015. The code is updated annually, and L90.0 remains current in the 2025 ICD-10-CM edition, effective from October 1, 2024. It’s important to note that while this is the American ICD-10-CM version, international versions of ICD-10 for lichen sclerosus may differ.
Understanding “Type 2 Excludes” for L90.0
The ICD-10-CM system uses “excludes” notes to clarify code usage. L90.0 has a “Type 2 Excludes” note, which is crucial for coders. A “Type 2 Excludes” note indicates that a particular condition is not included within the L90.0 classification. However, importantly, it also signifies that a patient can have both the condition coded under L90.0 (lichen sclerosus) and the excluded condition simultaneously. In such cases, both codes can and should be used to provide a complete and accurate medical picture.
Clinical Context of Lichen Sclerosus (L90.0)
Clinically, lichen sclerosus is recognized as a chronic inflammatory mucocutaneous disease. It most commonly affects the female genitalia, specifically known as vulvar lichen sclerosus. In males, it manifests as balanitis xerotica obliterans. Historically, it has also been referred to as white spot disease or Csillag’s disease.
This condition is characterized by a chronic inflammatory process impacting the skin. Key features include the development of white, indurated plaques, alongside epidermal atrophy (thinning of the skin’s outer layer), and fibrosis (scarring) of the upper dermis. While frequently observed in the vulva and penis, lichen sclerosus can occur in other skin areas as well.
Code History and Related ICD-10-CM Codes
L90.0 was introduced as a new code in the 2016 ICD-10-CM edition, effective October 1, 2015, marking the first year of the non-draft ICD-10-CM system. Since then, there have been no changes to the code through the 2025 edition, indicating its continued relevance and accuracy in classifying lichen sclerosus et atrophicus.
Within the broader ICD-10-CM classification, L90.0 falls under the category L90, which encompasses “Atrophic disorders of skin”. This section is situated within the larger chapter “Diseases of the skin and subcutaneous tissue” (L00-L99). Codes adjacent to L90.0 in the ICD-10-CM manual address other skin conditions, including pressure ulcers (L89.-) and other specific atrophic disorders of the skin (L90.1-L90.9), providing a detailed and hierarchical system for dermatological diagnoses.
Accurate utilization of diagnosis code L90.0 is vital for precise medical documentation, insurance processing, and public health statistics related to lichen sclerosus.
