Question 1

What is ICD-10 code L02.511?

Accepted Answer

L02.511 is the ICD-10-CM diagnosis code for cutaneous abscess of right hand. A localized collection of pus in the skin and tissue of the right hand, typically caused by a bacterial infection. L02.511 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering infections of the skin and subcutaneous tissue (l00-l08).

L02.511 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Confirm the abscess is specifically on the right hand rather than the forearm or wrist.

Question 2

Is L02.511 an HCC code?

Accepted Answer

No. L02.511 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is L02.511 billable?

Accepted Answer

Yes. L02.511 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. L02.511 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for L02.511?

Accepted Answer

L02.511 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards L02.511 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting L02.511?

Accepted Answer

Confirm the abscess is specifically on the right hand rather than the forearm or wrist Distinguish from furuncles (single boils) which have separate codes

L02.511

Is L02.511 an HCC code?

What This Code Means

Coding Tips

Code Hierarchy

Open L02.511 in the Interactive Encoder