L55.0
BillableSunburn of first degree
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is L55.0 an HCC code?
No. L55.0 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
L55.0 is the ICD-10-CM diagnosis code for sunburn of first degree. First-degree sunburn, which causes redness and mild pain but no blistering or severe damage to the skin. L55.0 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering radiation-related disorders of the skin and subcutaneous tissue (l55-l59).
L55.0 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.
First-degree sunburn is characterized by erythema only without blistering; document the extent and location if affecting multiple body areas.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L55.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •First-degree sunburn is characterized by erythema only without blistering; document the extent and location if affecting multiple body areas
- •Consider if this is an initial encounter, follow-up, or sequela to assign the appropriate 7th character