L55 vs T67.09XA
L55 (Sunburn) compared with T67.09XA (Other heatstroke and sunstroke, initial encounter), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. T67.09XA carries an Excludes1 note covering L55: “radiation-related disorders of the skin and subcutaneous tissue (L55-L59)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. T67.09XA carries an Excludes2 note covering L55: “sunburn (L55.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| L55Sunburn | T67.09XAOther heatstroke and sunstroke, initial encounter | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | L00-L99 — Diseases of the Skin and Subcutaneous Tissue (L00-L99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Sunburn is a non-billable ICD-10-CM category code (L55). | Other heatstroke and sunstroke, initial encounter is a billable ICD-10-CM diagnosis code (T67.09A). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T67 |
| Use additional code | — | code(s) to identify any associated complications of heatstroke, such as: coma and stupor (R40.-) rhabdomyolysis (M62.82) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources