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Derma

ICD-10 Codes for Skin & Subcutaneous Tissue

Diseases of the Skin & Subcutaneous Tissue

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L00-L08 Infections of the skin and subcutaneous tissue
L10-L14 Bullous disorders
L20-L30 Dermatitis and eczema
L40-L45 Papulosquamous disorders
L49-L54 Urticaria and erythema
L55-L59 Radiation-related disorders of the skin and subcutaneous tissue
L60-L75 Disorders of skin appendages
L76 Intraoperative and postprocedural complications of skin and subcutaneous tissue
L80-L99 Other disorders of the skin and subcutaneous tissue

Assessment

Assessment of integumentary system includes:

  • Activities, positioning, & postures that produce or relieve trauma to skin (observations, pressure-sensing maps, scales)

  • Assistive, adaptive, orthotic, protective, supportive equipment that may produce or relieve trauma to skin

  • Skin characteristics

    • Blistering

    • Nail growth

    • Continuity of skin color

    • Sensation

    • Dermatitis

    • Temperature

    • Hair growth

    • Texture

    • Mobility

    • Turgor

    • Pitting edema

  • Burn description & quantification

  • Wound characteristics

    • Bleeding

    • Shape

    • Contraction

    • Staging, progression, & etiology

    • Size

    • Depth

    • Location

    • Pulses/vascular tests

From World Health Organization. International Statistical Classification of Diseases, ed. 10. http://apps.who.int/classifications/icd10/browse/2010/en with permission.

  • Drainage—serous, sanguinous, serosanguinous, or purulent

  • Tunneling

  • Exposed anatomical structures

  • Undermining

  • Odor

  • Periwound: girth, edema, etc.

  • Pigment

  • Pain

  • Presence of granulation tissue or necrosis

  • Wound scar tissue characteristics

    • Banding

    • Sensation

  • Signs of infection

    • Cultures

    • Observations

    • Palpation

    • Pliability

    • Texture

Classification of Burn Injury

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Classification of Burn Injury
Classification Sensation Blisters Color Appearance Healing
Superficial Pain/tenderness delayed Usually absent Red Dry, but edema may be present Healing occurs w/o scarring
Superficial partial thickness Severe pain Intact blisters Red Bubbled w/blisters, edema Minimal or no scarring
Deep partial thickness Painful, but less severe than superficial Broken Mixed red or waxy white Moderate edema/WET from broken blisters Healing occurs w/hypertrophic scars & keloids
Full thickness Anesthetic to pain & temp None White, brown, black, or red Hard, parchment- like eschar formation or leathery, dry Infection; grafts necessary/skin regenerates only from edges of burn
Subdermal Anesthetic None White, brown, black, or red Necrotic tissue throughout Extensive surgery necessary to remove necrotic tissue; may need to amputate

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Types of Burn Injuries
Type Cause Wound Characteristics
Thermal burns Skin exposed to flame

Wounds have irregular borders

Depth of injury varies
Sudden explosion or ignition of gases: flash burns

Exposed surfaces burned uniformly

Usually result in partial-thickness burns
Hot objects (metals): contact burns

Deep, sharply circumscribed wounds

All skin elements & underlying structures destroyed
Scald burns Contact w/hot liquids

Superficial wounds

Hot liquid remains in contact w/skin for time (immersion/clothing holding liquid in contact), deep-partial or full-thickness injuries result
Chemical From acids or strong alkalies

Tissue may be exposed for long periods unless washed immediately

Result in partial- or full-thickness damage
Electrical Electrical current

Cause well-circumscribed, deep injuries involving muscle, tendon, ...

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