L57.1
BillableActinic reticuloid
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is L57.1 an HCC code?
No. L57.1 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
L57.1 is the ICD-10-CM diagnosis code for actinic reticuloid. A rare skin condition that develops from chronic sun exposure, characterized by a net-like or lacy pattern of skin changes, often accompanied by itching or burning sensations. L57.1 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).
L57.1 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.
This is a less common diagnosis; ensure clinical documentation clearly supports this diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L57.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a less common diagnosis; ensure clinical documentation clearly supports this diagnosis
- •Document associated symptoms and any photosensitivity history