Skip to content

L05 ICD-10-CM Code: Pilonidal cyst and sinus

L05 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Infections of the skin and subcutaneous tissue (L00-L08)

L05

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Pilonidal cyst and sinus

Pilonidal cyst and sinus

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
L0Infections of the skin and subcutaneous tissue (L00-L08)
L05Pilonidal cyst and sinus

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L05 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L05 in this effective period.

Related Child Codes

Official
L05.0Pilonidal cyst and sinus with abscess
L05.9Pilonidal cyst and sinus without abscess

Includes

Official

ICD-10-CM does not list Includes notes for L05 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L05 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L05 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L05 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L05 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
L05
Description
Pilonidal cyst and sinus
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

L05 is the ICD-10-CM diagnosis code for pilonidal cyst and sinus. L05 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).

Header codes like L05 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at L05's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L05 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

L05Pilonidal cyst and sinus
L05Pilonidal cyst and sinus

Work L05 in HCC Buddy

Open L05 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.