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L02.216 ICD-10-CM Code: Cutaneous abscess of umbilicus

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes1 · 21 Excludes2 · 2 use-additional codes

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code to identify organism (B95-B96)
  • code (B95-B97) to identify infectious agent.
Excludes1Never report with this code
  • non-newborn omphalitis (L08.82)
  • omphalitis of newborn (P38.-)
Excludes2Not included here; may be reported together
  • abscess of breast (N61.1)
  • abscess of buttocks (L02.31)
  • abscess of female external genital organs (N76.4)
  • abscess of male external genital organs (N48.2, N49.-)

+17 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 573 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC (MDC 09)
  • MS-DRG 574 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC (MDC 09)
  • MS-DRG 575 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC (MDC 09)
  • MS-DRG 602 — CELLULITIS WITH MCC (MDC 09)
  • MS-DRG 603 — CELLULITIS WITHOUT MCC (MDC 09)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for L02.216 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on L02.216 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from L02.2

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify organism (B95-B96) inherited from L02
  • Use additional code (B95-B97) to identify infectious agent. inherited from L00-L08

Coder workflow for L02.216

MedCoder structured workflow — derived from this code’s own official record

Before you code L02.216

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with L02.216. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in L02.216’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewL08.82, P38

Consider L02.216. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes1 — check before selecting L02.216(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with L02.216: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareL08.82, P38

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of L02.216(21 notes)

    Coding workflow: The conditions named in this note are not included in L02.216. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareN61.1, L02.31, N76.4, N48.2, N49, L02.4

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying L02.216(2 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with L02.216 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition L02.216 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewL08.82, P38

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with L02.216?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse L02.216 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of L02.216 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • L08.82— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of non-newborn omphalitis moves the case to L08.82; the two are not reported together unless documented as unrelated.

    Full comparison: L02.216 vs L08.82 →

  • P38— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of omphalitis of newborn moves the case to P38; the two are not reported together unless documented as unrelated.

    Full comparison: L02.216 vs P38 →

  • L02.219— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Cutaneous abscess of trunk, unspecified” takes L02.219; specificity in the record moves it back here.

    Full comparison: L02.216 vs L02.219 →

  • N61.1— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of abscess of breast adds N61.1; it is not part of this code and both may be reported when both are documented.

    Full comparison: L02.216 vs N61.1 →

  • L02.31— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of abscess of buttocks adds L02.31; it is not part of this code and both may be reported when both are documented.

    Full comparison: L02.216 vs L02.31 →

  • N76.4— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of abscess of female external genital organs adds N76.4; it is not part of this code and both may be reported when both are documented.

    Full comparison: L02.216 vs N76.4 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Cutaneous abscess of umbilicus is a billable ICD-10-CM diagnosis code (L02.216).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 2 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 2 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 21 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name L02.216 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 4 Excludes2 notes: L89 — Pressure ulcer (via L02.-), L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified (via L02.-), L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified (via L02.-), L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified (via L02.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Use Additional Code instruction: T65.84 — Toxic effect of xylazine (via L02.-).

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 67 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 7 MS-DRGs: DRG 573 (MDC 09), DRG 574 (MDC 09), DRG 575 (MDC 09), DRG 602 (MDC 09), DRG 603 (MDC 09), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SKN001 — Skin and subcutaneous tissue infections (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

A49.3 — Mycoplasma infection, unspecified site, A49.8 — Other bacterial infections of unspecified site, A49.9 — Bacterial infection, unspecified, B78.1 — Cutaneous strongyloidiasis, E83.2 — Disorders of zinc metabolism, L02.211 — Cutaneous abscess of abdominal wall, L02.212 — Cutaneous abscess of back [any part, except buttock and flank], L02.213 — Cutaneous abscess of chest wall, L02.214 — Cutaneous abscess of groin, L02.215 — Cutaneous abscess of perineum, L02.217 — Cutaneous abscess of flank, L02.219 — Cutaneous abscess of trunk, unspecified, L02.811 — Cutaneous abscess of head [any part, except face], L02.818 — Cutaneous abscess of other sites, L02.91 — Cutaneous abscess, unspecified, L03.311 — Cellulitis of abdominal wall, L03.312 — Cellulitis of back [any part except buttock and flank], L03.313 — Cellulitis of chest wall, L03.314 — Cellulitis of groin, L03.315 — Cellulitis of perineum, +46 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Skin and subcutaneous tissue infections).

L02.02 — Furuncle of face, L02.03 — Carbuncle of face, L02.11 — Cutaneous abscess of neck, L02.12 — Furuncle of neck, L02.13 — Carbuncle of neck, L02.211 — Cutaneous abscess of abdominal wall, L02.212 — Cutaneous abscess of back [any part, except buttock and flank], L02.213 — Cutaneous abscess of chest wall, L02.214 — Cutaneous abscess of groin, L02.215 — Cutaneous abscess of perineum, L02.217 — Cutaneous abscess of flank, L02.219 — Cutaneous abscess of trunk, unspecified, L02.221 — Furuncle of abdominal wall, L02.222 — Furuncle of back [any part, except buttock and flank], L02.223 — Furuncle of chest wall, L02.224 — Furuncle of groin, L02.225 — Furuncle of perineum, L02.226 — Furuncle of umbilicus, L02.227 — Furuncle of flank, L02.229 — Furuncle of trunk, unspecified, +150 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Abscess”; these codes share that main term but sit in a different category of the Tabular List.

K65.1 — Peritoneal abscess (omentum), K68.11 — Postprocedural retroperitoneal abscess (postoperative, retroperitoneal), K68.12 — Psoas muscle abscess (psoas muscle), K68.19 — Other retroperitoneal abscess (presacral), K6A.01 — Prevesical abscess (prevesical), K6A.09 — Other pelvic abscess (pelvis, pelvic), K75.0 — Abscess of liver (liver), K81.0 — Acute cholecystitis (gallbladder), K94.02 — Colostomy infection (colostomy), K94.12 — Enterostomy infection (ileostomy), L04.0 — Acute lymphadenitis of face, head and neck (neck, lymph gland or node), L04.1 — Acute lymphadenitis of trunk (inguinal, lymph gland or node), L04.2 — Acute lymphadenitis of upper limb (axilla, lymph gland or node), L05.01 — Pilonidal cyst with abscess (pilonidal), L74.8 — Other eccrine sweat disorders (sweat gland), L75.8 — Other apocrine sweat disorders (sudoriparous), M00.9 — Pyogenic arthritis, unspecified (knee, joint), M27.2 — Inflammatory conditions of jaws (jaw), M46.28 — Osteomyelitis of vertebra, sacral and sacrococcygeal region (sacrum, nontuberculous), M65.00 — Abscess of tendon sheath, unspecified site (tendon), +143 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HIV Screening Test

Contextual Map

Every relationship of L02.216 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run L02.216 with these 5 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions

  • T65.84 — Toxic effect of xylazine[Use Additional Code](via L02.-): “cutaneous abscess, furuncle and carbuncle (L02.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 09 — Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast[MDC crossing]: “Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 7,378 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic), navel[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic), trunk, umbilicus[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic), umbilicus[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (40)

Change history (3)

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "L02.216 — Cutaneous abscess of umbilicus." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/l02.216-cutaneous-abscess-of-umbilicus

Change history

Changed in FY2027, the release in force: Excludes2 note added; Excludes2 note removed.

  • FY2027 — October 1, 2026
    Excludes2 note added
    abscess of buttocks (L02.31)
    FY2027 changes
  • FY2027 — October 1, 2026
    Excludes2 note removed
    abscess of buttocks (L02.3)
    FY2027 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cutaneous abscess of umbilicus

Nearest Codes in This Family

Official ICD-10-CM classifications closest to L02.216 in its code family, with their registry titles.

View all codes in the L02 family