Understanding Impetigo Infection and Associated ICD 10 Diagnosis Codes

Understanding Impetigo and ICD 10 Codes

Impetigo is a common and highly contagious bacterial skin infection that typically affects children aged 2-5 years old. The infection causes red sores or blisters to form on the face, usually around the nose and mouth area. The sores can also appear on other parts of the body, such as the hands, legs, and diaper area. Impetigo is not usually a serious infection, but it is important to treat it promptly to help prevent complications and transmission to others.

Causes of Impetigo

Impetigo is caused by two types of bacteria - Streptococcus pyogenes or Staphylococcus aureus. These bacteria can invade damaged skin, such as cuts, scrapes, bug bites, or rashes. The infection spreads easily through close contact and can also be spread through shared towels, clothes, toys, or other personal items. Impetigo is contagious for as long as the sores continue to weep fluid. With treatment, a person is usually no longer contagious after 24-48 hours.

Symptoms of Impetigo

The main symptoms of impetigo include:

• Red sores, blisters, or pustules that rupture easily and leak a clear or honey-colored fluid.
• Sores that are surrounded by redness and itching.
• Crusting over the sores after they rupture.
• Sores that spread quickly to other areas.
• Swollen lymph nodes near the affected area.

The sores usually start out as small red bumps or blisters and can become large, red, and swollen with a yellowish crust. There are two main types of impetigo:

• Nonbullous impetigo - This is the most common form which causes sores to rupture, ooze, and crust over.
• Bullous impetigo - This leads to larger blisters that don't rupture as easily but leave a thin, fragile crust when they do burst.

Risk Factors and Complications

Anyone can get impetigo but there are some factors that increase risk:

• Being a child aged 2-5 years.
• Living in hot, humid climates.
• Having other skin problems like eczema, insect bites, cuts, scrapes.
• Having a weak immune system.
• Participating in close contact sports like wrestling.
• Poor hygiene practices.

While impetigo is generally not serious, complications can sometimes occur including:

• Cellulitis - a more serious bacterial skin infection.
• Guttate psoriasis - a type of psoriasis triggered by impetigo.
• Kidney inflammation (post-streptococcal glomerulonephritis).
• Rheumatic fever - inflammation following a strep skin infection.

Treatment helps lower the risk of developing complications. Seeking prompt medical care is important, especially if symptoms worsen or persist.

Diagnosing Impetigo

Impetigo is often diagnosed simply through a physical examination of the characteristic signs and symptoms. The doctor may take a sample of fluid from a sore and send it for testing to determine the exact strain of bacteria involved. Testing helps guide treatment options.

Impetigo Treatment

Treatment aims to stop the infection, prevent spreading, and reduce complications. Options may include:

• Antibiotic ointments - Mild cases may be treated with topical antibiotics like mupirocin or retapamulin applied to the sores for 5-10 days.
• Oral antibiotics - For more severe or widespread impetigo, oral antibiotics are prescribed such as cephalexin, amoxicillin, azithromycin or penicillin. The usual course is 7-10 days.
• Wound care - Keeping sores clean, loosely covered, and dry helps prevent infection spread. Antiseptic soaks may also be used.
• Trimmed fingernails - To discourage scratching and reduce bacterial spread.
• Good hygiene - Frequent handwashing, daily bathing, regularly cleaning shared surfaces and clothes.

In addition to medication, there are some home remedies that can aid impetigo healing:

• Applying a warm compress to help drain fluid from blisters.
• Gently removing crusts after soaking to expose sores to air.
• Diluted apple cider vinegar - contains antibacterial acetic acid.
• Diluted tea tree oil - has antimicrobial effects.

Avoid bursting blisters intentionally and keep fingernails short to prevent infecting new areas. See a doctor quickly if symptoms persist or worsen despite home treatment. Prescription antibiotic therapy is often needed to fully resolve impetigo.

Preventing Impetigo

Practicing good hygiene and first aid care can help prevent impetigo infections:

• Covering cuts, scrapes with clean bandages until healed.
• Regular handwashing with soap and water.
• Avoiding close contact with infected people.
• Not sharing personal items like towels, clothes, bedding.
• Disinfecting surfaces, toys, shared equipment.
• Treating and covering other skin problems like insect bites.
• Trimming fingernails to prevent scratching and spread.

Children and those in contact with someone actively infected should also talk to their doctor about antibiotic prophylaxis to prevent transmission of infection.

ICD 10 Codes for Impetigo

ICD 10 codes are used to document medical diagnoses and procedures. Impetigo has some specific ICD 10 codes that are used:

L00 - Impetigo

This code indicates impetigo or any erysipelas of the skin. It is used when the impetigo is unspecified or the initial diagnosis.

L00.0 - Impetigo [any organism] [any site]

This code specifies impetigo caused by any organism and occurring on any part of the body.

L00.1 - Impetiginization of other dermatoses

This code indicates impetigo has resulted as a secondary infection to another skin condition like eczema, seborrheic dermatitis, or psoriasis.

L00.2 - Cutaneous abscess, furuncle and carbuncle

This code is used when impetigo leads to a skin abscess, boil, or deeper skin infection involving a hair follicle or oil gland.

L00.8 - Other impetigo

This code specifies other variations of impetigo not classified by other L00 codes, such as impetigo contagiosa.

L00.9 - Impetigo, unspecified

This code indicates impetigo has been diagnosed but the specific type is not documented.

L01 - Impetigo

Category L01 contains codes indicating impetigo caused by specific organisms when known:

• L01.00 - Impetigo due to unspecified organism
• L01.01 - Impetigo due to staphylococcus aureus
• L01.02 - Impetigo due to group A streptococcus
• L01.03 - Impetigo due to other streptococcus
• L01.09 - Other impetigo

L01.1 - Impetiginization of other dermatoses

This code parallels L00.1, indicating impetigo as a secondary infection of an underlying skin condition. The specific organism is known in this case.

B08.5 - Staphylococcal scalded skin syndrome

This code indicates bullous impetigo caused by staphylococcus aureus which can result in staphylococcal scalded skin syndrome, a widespread blistering rash.

Tips for Coding Impetigo

Here are some tips for accurately coding any diagnoses of impetigo:

• Use L00 codes for initial or unspecified impetigo.
• Use L01 codes if the causative organism has been identified.
• Code the underlying dermatosis (eczema, psoriasis etc) separately if applicable.
• Use additional codes for any associated cellulitis (L03.-) or abscess (L02.01).
• Code bullous impetigo separately (L00.0 and B08.5).
• Capture severity if applicable - mild (L00.0), moderate (L00.1), severe (L00.2).
• Code Z16.33 for contact with/exposure to strep, if screening swab done.

Clear, detailed ICD 10 coding helps communicate the specifics of each impetigo case so the proper medical record documentation and insurance reimbursement processes can be completed.

The Outlook for Impetigo

With prompt diagnosis and antibiotic treatment, most cases of impetigo resolve within a couple weeks without further issues. Practice good hygiene and wound care to help prevent the very contagious infection from occurring or spreading. Seek medical advice quickly at the first signs of impetigo to get appropriate care and avoid complications.

Understanding the ICD 10 codes for impetigo ensures accurate medical coding and billing for the common bacterial skin infection. Being aware of the causes, symptoms, treatment, and prevention of impetigo helps improve care and outcomes for this condition often affecting school-aged kids.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.