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L49 ICD-10-CM Code: Exfoliation due to erythematous conditions according to extent of body surface involved

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FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Urticaria and erythema (L49-L54)

L49

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

Exfoliation due to erythematous conditions according to extent of body surface involved

Exfoliation due to erythematous conditions according to extent of body surface involved

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
L4Urticaria and erythema (L49-L54)
L49Exfoliation due to erythematous conditions according to extent of body surface involved

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L49 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L49 in this effective period.

Related Child Codes

Official
L49.0Exfoliation due to erythematous condition involving less than 10 percent of body surface
L49.1Exfoliation due to erythematous condition involving 10-19 percent of body surface
L49.2Exfoliation due to erythematous condition involving 20-29 percent of body surface
L49.3Exfoliation due to erythematous condition involving 30-39 percent of body surface
L49.4Exfoliation due to erythematous condition involving 40-49 percent of body surface

Includes

Official

ICD-10-CM does not list Includes notes for L49 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L49 in this effective period.

Code First

Official
  • erythematous condition causing exfoliation, such as:
  • Ritter's disease (L00)
  • (Staphylococcal) scalded skin syndrome (L00)
  • Stevens-Johnson syndrome (L51.1)
  • Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome (L51.3)

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L49 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L49 in this effective period.

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.

Coder workflow notes

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What This Code Means

L49 is the ICD-10-CM diagnosis code for exfoliation due to erythematous conditions according to extent of body surface involved. L49 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering urticaria and erythema (l49-l54).

Header codes like L49 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 L49'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 L49 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Code First

  • erythematous condition causing exfoliation, such as:
  • Ritter's disease (L00)
  • (Staphylococcal) scalded skin syndrome (L00)
  • Stevens-Johnson syndrome (L51.1)
  • Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome (L51.3)
  • Toxic epidermal necrolysis (L51.2)

Child Codes

Code Hierarchy

L49Exfoliation due to erythematous conditions according to extent of body surface involved
L49Exfoliation due to erythematous conditions according to extent of body surface involved

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