Question 1

What is ICD-10 code L26?

Accepted Answer

L26 is the ICD-10-CM diagnosis code for exfoliative dermatitis. A severe skin condition where large areas of skin become inflamed, red, and shed or peel off, often as a reaction to medications, infections, or other triggers. L26 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering dermatitis and eczema (l20-l30).

L26 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.

This is a serious condition requiring investigation for underlying cause; document any triggering medications or systemic illness.

Question 2

Is L26 an HCC code?

Accepted Answer

No. L26 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 L26 billable?

Accepted Answer

Yes. L26 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. L26 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 L26?

Accepted Answer

L26 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 L26 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 L26?

Accepted Answer

This is a serious condition requiring investigation for underlying cause; document any triggering medications or systemic illness Exfoliative dermatitis can be life-threatening; ensure appropriate severity documentation and monitoring

HCC Buddy Code Card

L26

Is L26 an HCC code?

What This Code Means

Coding Tips

Excludes 1, Do NOT code together

Code Hierarchy

Open L26 in the Interactive Encoder

L26 ICD-10-CM Code: Exfoliative dermatitis

HCC Buddy Code Card

L26

Is L26 an HCC code?

What This Code Means

Coding Tips

Excludes 1, Do NOT code together

Code Hierarchy

Open L26 in the Interactive Encoder