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L41.1 ICD-10-CM Code: Pityriasis lichenoides chronica

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FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Papulosquamous disorders (L40-L45)

L41.1

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

Pityriasis lichenoides chronica

A chronic inflammatory skin condition with persistent small lesions that develop slowly and may last for extended periods.

Buddy the Bee presenting code insight

Buddy Insight

Pityriasis lichenoides chronica is the chronic form of pityriasis lichenoides, characterized by recurrent crops of small scaling papules that may persist for months to years.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

HCC 316

RAF 0.0

Code Trumping

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Code Book Path

Official
L41Parapsoriasis
L41.1Pityriasis lichenoides chronica

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L41.1 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L41.1 in this effective period.

Related Child Codes

Official
L41.0Pityriasis lichenoides et varioliformis acuta
L41.3Small plaque parapsoriasis
L41.4Large plaque parapsoriasis
L41.5Retiform parapsoriasis
L41.8Other parapsoriasis

Includes

Official

ICD-10-CM does not list Includes notes for L41.1 in this effective period.

Excludes 1

Official
  • poikiloderma vasculare atrophicans (L94.5)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L41.1 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L41.1 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L41.1 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation of pityriasis lichenoides chronica
Clinical description of chronic recurrent scaling papules
Duration of disease and pattern of recurrence
Biopsy results if obtained to distinguish from mycosis fungoides

MEAT Support

HCC Buddy guidance
Provider documentation of pityriasis lichenoides chronica
Clinical description of chronic recurrent scaling papules
Duration of disease and pattern of recurrence
Biopsy results if obtained to distinguish from mycosis fungoides

Audit Caution

HCC Buddy guidance
Confusing with the acute form (PLEVA) which has different severity and management
Failing to distinguish from early mycosis fungoides which requires biopsy
Using a generic dermatitis code when pityriasis lichenoides chronica is specifically documented
Confusing with guttate psoriasis based on similar appearance of small papules

Common Mistakes

HCC Buddy guidance
L41.0 (Pityriasis lichenoides et varioliformis acuta) — acute form with more inflammatory, necrotic lesions
C84.0 (Mycosis fungoides) — cutaneous T-cell lymphoma that can be histologically similar
L42 (Pityriasis rosea) — self-limited condition with different morphology and course
L40.4 (Guttate psoriasis) — small papules but with psoriatic scale and different histology

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 L41.1 an HCC code?

No. L41.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 316, Psoriasis
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 L41.1

For L41.1to 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 L41.1 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

L41.1 is the ICD-10-CM diagnosis code for pityriasis lichenoides chronica. A chronic inflammatory skin condition with persistent small lesions that develop slowly and may last for extended periods. L41.1 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering papulosquamous disorders (l40-l45).

L41.1 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.

Does not map to any CMS-HCC in V28, V24, or ESRD models. Maps only to RxHCC 316 (Psoriasis and Other Papulosquamous Disorders) for prescription drug risk adjustment. No direct Medicare Advantage RAF score impact. Coders reviewing L41.1 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L41.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Verify the chronic nature and duration of the condition to differentiate from the acute form (L41.0)
  • Document any remissions or exacerbations in the clinical course

Clinical Significance

Pityriasis lichenoides chronica is the chronic form of pityriasis lichenoides, characterized by recurrent crops of small scaling papules that may persist for months to years. While generally benign, it requires monitoring because of a small but recognized risk of progression to cutaneous T-cell lymphoma (mycosis fungoides). Long-term follow-up is essential for early detection of malignant transformation.

Documentation Requirements

  • Provider documentation of pityriasis lichenoides chronica
  • Clinical description of chronic recurrent scaling papules
  • Duration of disease and pattern of recurrence
  • Biopsy results if obtained to distinguish from mycosis fungoides
  • Current treatment plan (topical steroids, phototherapy)
  • Monitoring plan for potential lymphomatous transformation

Commonly Confused Codes

  • L41.0 (Pityriasis lichenoides et varioliformis acuta) — acute form with more inflammatory, necrotic lesions
  • C84.0 (Mycosis fungoides) — cutaneous T-cell lymphoma that can be histologically similar
  • L42 (Pityriasis rosea) — self-limited condition with different morphology and course
  • L40.4 (Guttate psoriasis) — small papules but with psoriatic scale and different histology

Child Codes

Code Hierarchy

L41ParapsoriasisL41.1Pityriasis lichenoides chronica
L41.1Pityriasis lichenoides chronica

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