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L10.2 ICD-10-CM Code: Pemphigus foliaceous

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FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Bullous disorders (L10-L14)

L10.2

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Pemphigus foliaceous

A superficial form of pemphigus where blisters form in the outermost layer of skin, typically affecting the face, chest, and back.

Buddy the Bee presenting code insight

Buddy Insight

Pemphigus foliaceus is a superficial form of pemphigus with better prognosis than vulgaris but still requires immunosuppressive therapy.

CMS-HCC V28

HCC 387

RAF 0.262

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

HCC 314

RAF 0.0

Code Trumping

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Code Book Path

Official
L10Pemphigus
L10.2Pemphigus foliaceous

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L10.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L10.2 in this effective period.

Related Child Codes

Official
L10.0Pemphigus vulgaris
L10.1Pemphigus vegetans
L10.3Brazilian pemphigus [fogo selvagem]
L10.4Pemphigus erythematosus
L10.5Drug-induced pemphigus

Includes

Official

ICD-10-CM does not list Includes notes for L10.2 in this effective period.

Excludes 1

Official
  • pemphigus neonatorum (L01.03)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L10.2 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L10.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L10.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Clinical presentation with superficial blisters and crusts
Absence of mucosal involvement
Histopathologic findings showing superficial acantholysis
Direct immunofluorescence with intercellular IgG deposits

MEAT Support

HCC Buddy guidance
Clinical presentation with superficial blisters and crusts
Absence of mucosal involvement
Histopathologic findings showing superficial acantholysis
Direct immunofluorescence with intercellular IgG deposits

Audit Caution

HCC Buddy guidance
Confusing with pemphigus vulgaris when mucosa not involved
Missing documentation of superficial nature
Using Brazilian pemphigus codes for non-endemic areas
Confusing with seborrheic dermatitis or psoriasis

Common Mistakes

HCC Buddy guidance
L10.0 — Pemphigus vulgaris with mucosal involvement
L40.0 — Psoriasis vulgaris with similar scaling
L30.3 — Infectious eczematoid dermatitis
L21.0 — Seborrheic dermatitis of scalp

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is L10.2 an HCC code?

Yes. L10.2 maps to Pemphigus and Other Autoimmune Skin Conditions under the CMS-HCC V28 risk adjustment model.

HCC Category Mapping

V28HCC 387, Pemphigus and Other Autoimmune Skin Conditions
0.262
RxHCCHCC 314, Pemphigus
0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for L10.2

For L10.2to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed L10.2 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

L10.2 is the ICD-10-CM diagnosis code for pemphigus foliaceous. A superficial form of pemphigus where blisters form in the outermost layer of skin, typically affecting the face, chest, and back. L10.2 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering bullous disorders (l10-l14).

Under the CMS-HCC V28 risk adjustment model, L10.2 maps to Pemphigus and Other Autoimmune Skin Conditions (HCC 387) with a community, non-dual, aged base RAF weight of 0.262. L10.2 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Document that blisters are superficial and flaccid, distinguishing from deeper pemphigus vulgaris. Because L10.2 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L10.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document that blisters are superficial and flaccid, distinguishing from deeper pemphigus vulgaris
  • Note the typical distribution pattern (seborrheic areas) in clinical documentation

Clinical Significance

Pemphigus foliaceus is a superficial form of pemphigus with better prognosis than vulgaris but still requires immunosuppressive therapy. This diagnosis indicates an autoimmune blistering disease that primarily affects the skin without significant mucosal involvement.

Documentation Requirements

  • Clinical presentation with superficial blisters and crusts
  • Absence of mucosal involvement
  • Histopathologic findings showing superficial acantholysis
  • Direct immunofluorescence with intercellular IgG deposits
  • Desmoglein-1 antibody positivity
  • Distribution pattern documentation (face, chest, back)
  • Treatment response to immunosuppressive therapy
  • Disease severity assessment

Commonly Confused Codes

  • L10.0: Pemphigus vulgaris with mucosal involvement
  • L40.0: Psoriasis vulgaris with similar scaling
  • L30.3: Infectious eczematoid dermatitis
  • L21.0: Seborrheic dermatitis of scalp
  • L10.3: Fogo selvagem (Brazilian pemphigus)

Child Codes

Code Hierarchy

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