What is ICD-10 code L93.0?

L93.0 is the ICD-10-CM diagnosis code for Discoid lupus erythematosus. A chronic autoimmune skin condition causing a butterfly-shaped rash across the cheeks and nose, or scaly, coin-shaped patches on other parts of the body. L93.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L93.0 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. L93.0 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. L93.0 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.

Which HCC does L93.0 map to under V28?

L93.0 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

What does L93.0 pay in RAF?

L93.0 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

What is the V28 vs V24 difference for L93.0?

L93.0 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 community model rewards L93.0 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. It does, however, map under the Part D RxHCC model (Lupus, Cutaneous), which affects the ESRD and/or Part D (RxHCC) risk scores. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

What documentation supports L93.0?

Document whether this is cutaneous-only lupus or if there are systemic manifestations requiring additional coding Note the specific distribution and appearance of lesions (malar, discoid, etc.) for clinical clarity L93.0 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM L93.0: Discoid lupus erythematosus

L93.0 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupL93.0Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)

L93.0

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

Discoid lupus erythematosus

A chronic autoimmune skin condition causing a butterfly-shaped rash across the cheeks and nose, or scaly, coin-shaped patches on other parts of the body.

Buddy Insight

Discoid lupus erythematosus is a chronic autoimmune skin condition causing coin-shaped (discoid) erythematous plaques that can result in scarring, atrophy, and permanent hair loss.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 317

Lupus, Cutaneous

RAF 0.113

Code Book Path

Official

L93Lupus erythematosus

L93.0Discoid lupus erythematosus

Inclusion Terms

Official

Lupus erythematosus NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L93.0 in this effective period.

Related Child Codes

Official

L93.1Subacute cutaneous lupus erythematosus

L93.2Other local lupus erythematosus

Includes

Official

ICD-10-CM does not list Includes notes for L93.0 in this effective period.

Excludes 1

Official

lupus exedens (A18.4)
lupus vulgaris (A18.4)
scleroderma (M34.-)
systemic lupus erythematosus (M32.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L93.0 in this effective period.

Use Additional

Official

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Code Also

Official

ICD-10-CM does not list Code Also instructions for L93.0 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Clinical description of discoid lesions (erythematous plaques, scaling, scarring)

Distribution and anatomical locations affected (face, scalp, ears are most common)

Biopsy results if performed (interface dermatitis, follicular plugging)

Serologic workup results (antinuclear antibody, anti-dsDNA) to rule out systemic disease

MEAT Support

HCC Buddy guidance

Clinical description of discoid lesions (erythematous plaques, scaling, scarring)

Distribution and anatomical locations affected (face, scalp, ears are most common)

Biopsy results if performed (interface dermatitis, follicular plugging)

Serologic workup results (antinuclear antibody, anti-dsDNA) to rule out systemic disease

Audit Caution

HCC Buddy guidance

Do not assign L93.0 when the patient has systemic lupus erythematosus with skin involvement — use M32.x codes instead

Discoid lupus and subacute cutaneous lupus are distinct entities; review dermatology notes for specific terminology

If documentation mentions 'lupus' without clarification, query the provider to determine if it is cutaneous-only or systemic

Do not assign L93.0 based solely on a positive ANA — clinical findings must support the diagnosis

Common Mistakes

HCC Buddy guidance

M32.9 — Systemic lupus erythematosus, unspecified; discoid lupus (L93.0) is skin-limited while SLE is multi-organ

L93.1 — Subacute cutaneous lupus erythematosus has annular or papulosquamous non-scarring lesions, unlike the scarring discoid plaques

L93.2 — Other local lupus erythematosus covers variants not classified as discoid or subacute cutaneous

L56.4 — Polymorphous light eruption can mimic lupus but is not autoimmune

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is L93.0 an HCC code?

L93.0 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Lupus, Cutaneous under the Part D RxHCC model.

Code: L93.0
Description: Discoid lupus erythematosus
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 317, Lupus, Cutaneous

0.113

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work L93.0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for L93.0

For L93.0 to 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 L93.0 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

L93.0 is the ICD-10-CM diagnosis code for discoid lupus erythematosus. A chronic autoimmune skin condition causing a butterfly-shaped rash across the cheeks and nose, or scaly, coin-shaped patches on other parts of the body. L93.0 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering other disorders of the skin and subcutaneous tissue (l80-l99).

L93.0 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.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing L93.0 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 L93.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document whether this is cutaneous-only lupus or if there are systemic manifestations requiring additional coding
•Note the specific distribution and appearance of lesions (malar, discoid, etc.) for clinical clarity

Clinical Significance

Discoid lupus erythematosus is a chronic autoimmune skin condition causing coin-shaped (discoid) erythematous plaques that can result in scarring, atrophy, and permanent hair loss. Unlike systemic lupus erythematosus, discoid lupus is typically limited to the skin, though approximately 5-10% of patients may progress to systemic disease. Accurate capture matters for monitoring autoimmune disease burden and ensuring appropriate dermatologic and rheumatologic follow-up.

Documentation Requirements

✓Clinical description of discoid lesions (erythematous plaques, scaling, scarring)
✓Distribution and anatomical locations affected (face, scalp, ears are most common)
✓Biopsy results if performed (interface dermatitis, follicular plugging)
✓Serologic workup results (antinuclear antibody, anti-dsDNA) to rule out systemic disease
✓Current treatment plan (topical corticosteroids, antimalarials, immunosuppressants)
✓Assessment for progression to systemic lupus erythematosus
✓Impact on quality of life (scarring, disfigurement, alopecia)

Commonly Confused Codes

•M32.9: Systemic lupus erythematosus, unspecified; discoid lupus (L93.0) is skin-limited while SLE is multi-organ
•L93.1: Subacute cutaneous lupus erythematosus has annular or papulosquamous non-scarring lesions, unlike the scarring discoid plaques
•L93.2: Other local lupus erythematosus covers variants not classified as discoid or subacute cutaneous
•L56.4: Polymorphous light eruption can mimic lupus but is not autoimmune
•L40.0: Psoriasis vulgaris may appear similar with plaques and scaling but has different histopathology