What is ICD-10 code L94.5?

L94.5 is the ICD-10-CM diagnosis code for Poikiloderma vasculare atrophicans. A skin condition characterized by a lacy, net-like pattern of discoloration with thinning and atrophy of the affected skin. It belongs to the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99). L94.5 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L94.5 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. L94.5 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. L94.5 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.

What is the V28 vs V24 difference for L94.5?

L94.5 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 model rewards L94.5 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting L94.5?

This is a rare condition; ensure documentation clearly supports this diagnosis before coding Note the anatomical distribution, typically on the trunk and extremities

L94.5 ICD-10 Code: Poikiloderma vasculare

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupL94.5Effective 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)

L94.5

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

Poikiloderma vasculare atrophicans

A skin condition characterized by a lacy, net-like pattern of discoloration with thinning and atrophy of the affected skin.

Buddy Insight

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 316

Psoriasis

RAF 0.0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

L94Other localized connective tissue disorders

L94.5Poikiloderma vasculare atrophicans

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L94.5 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L94.5 in this effective period.

Related Child Codes

Official

L94.0Localized scleroderma [morphea]

L94.1Linear scleroderma

L94.2Calcinosis cutis

L94.3Sclerodactyly

L94.4Gottron's papules

Includes

Official

ICD-10-CM does not list Includes notes for L94.5 in this effective period.

Excludes 1

Official

systemic connective tissue disorders (M30-M36)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L94.5 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L94.5 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L94.5 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Clinical description of the characteristic triad: atrophy, telangiectasia, and pigmentary changes

Distribution and extent of affected skin areas

Duration and progression of skin changes

Biopsy results if performed (to exclude mycosis fungoides or other lymphoma)

MEAT Support

HCC Buddy guidance

Clinical description of the characteristic triad: atrophy, telangiectasia, and pigmentary changes

Distribution and extent of affected skin areas

Duration and progression of skin changes

Biopsy results if performed (to exclude mycosis fungoides or other lymphoma)

Audit Caution

HCC Buddy guidance

Do not assign L94.5 for poikiloderma of Civatte (sun-damaged neck skin) — that is a different condition

Always investigate for underlying malignancy (particularly mycosis fungoides) before assuming primary poikiloderma

If the poikiloderma is a manifestation of dermatomyositis, code both conditions with the dermatomyositis as the underlying etiology

Do not confuse with radiation-induced skin changes (L58.x) which can have a similar clinical appearance

Common Mistakes

HCC Buddy guidance

C84.0 — Mycosis fungoides; poikiloderma may be an early sign of cutaneous T-cell lymphoma requiring biopsy to differentiate

M33.10 — Dermatomyositis, unspecified; poikiloderma can be a feature of dermatomyositis

L57.3 — Poikiloderma of Civatte is a photodamage condition of the neck, distinct from vasculare atrophicans

L90.8 — Other atrophic disorders of skin; poikiloderma has specific features beyond simple atrophy

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 L94.5 an HCC code?

No. L94.5 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 L94.5

For L94.5to 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 L94.5 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

L94.5 is the ICD-10-CM diagnosis code for poikiloderma vasculare atrophicans. A skin condition characterized by a lacy, net-like pattern of discoloration with thinning and atrophy of the affected skin. L94.5 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).

L94.5 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 any CMS-HCC under V28, V24, or ESRD models. Under the RxHCC model, it maps to RxHCC 316 with a RAF weight of 0.0. Poikiloderma vasculare atrophicans has no direct risk adjustment RAF impact, but its potential association with cutaneous lymphoma or connective tissue disease makes accurate coding important for clinical surveillance purposes.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L94.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a rare condition; ensure documentation clearly supports this diagnosis before coding
•Note the anatomical distribution, typically on the trunk and extremities

Clinical Significance

Poikiloderma vasculare atrophicans is a chronic skin condition characterized by the triad of atrophy, telangiectasia, and pigmentary changes (hyper- and hypopigmentation), giving the skin a mottled appearance. It may occur as a primary dermatologic condition or secondary to connective tissue diseases, dermatomyositis, or cutaneous T-cell lymphoma (mycosis fungoides). Accurate documentation is critical because it may represent an early manifestation of malignancy or systemic autoimmune disease requiring further workup.

Documentation Requirements

✓Clinical description of the characteristic triad: atrophy, telangiectasia, and pigmentary changes
✓Distribution and extent of affected skin areas
✓Duration and progression of skin changes
✓Biopsy results if performed (to exclude mycosis fungoides or other lymphoma)
✓Assessment for underlying connective tissue disease or malignancy
✓Review for associated conditions (dermatomyositis, mycosis fungoides, radiation dermatitis)
✓Current treatment plan and dermatology follow-up schedule
✓Photographic documentation of lesions for progression monitoring

Commonly Confused Codes

•C84.0 — Mycosis fungoides; poikiloderma may be an early sign of cutaneous T-cell lymphoma requiring biopsy to differentiate
•M33.10 — Dermatomyositis, unspecified; poikiloderma can be a feature of dermatomyositis
•L57.3 — Poikiloderma of Civatte is a photodamage condition of the neck, distinct from vasculare atrophicans
•L90.8 — Other atrophic disorders of skin; poikiloderma has specific features beyond simple atrophy
•L81.9 — Disorder of pigmentation, unspecified; poikiloderma includes atrophy and telangiectasia, not just pigment change