What is the ICD (International Classification of Diseases) code for poison ivy?

ICD Code for Poison Ivy

The ICD-10-CM code for poison ivy contact dermatitis is L23.7 (Allergic contact dermatitis due to plants, except food). This is the appropriate diagnostic code to use when documenting poison ivy exposure and resulting dermatitis.

Understanding Poison Ivy Dermatitis

Poison ivy dermatitis is a form of allergic contact dermatitis caused by exposure to urushiol, the allergic compound found in Toxicodendron species (formerly Rhus), which includes poison ivy, poison oak, and poison sumac. This condition:

• Affects approximately 50-75% of the US adult population 1
• Results in millions of healthcare visits annually 2
• Typically presents with redness, papules, vesicles, and intense itching
• Usually begins within days of exposure and can last up to 3 weeks 2

Clinical Coding Considerations

When coding for poison ivy dermatitis:

1. Use L23.7 for allergic contact dermatitis due to plants
2. Document the specific plant exposure (poison ivy, oak, or sumac)
3. Note the affected body areas and severity
4. Include any complications if present

Management of Poison Ivy Dermatitis

Immediate Interventions

• Wash the exposed area with soap and water or a commercial decontamination product as soon as possible after exposure 2
  • Effectiveness of washing decreases rapidly with time:
    • 100% effective immediately after contact
    • 50% effective at 10 minutes
    • 25% effective at 15 minutes
    • 10% effective at 30 minutes 2

Treatment Options

1. Topical treatments:

   • Over-the-counter topical steroids have uncertain effectiveness 2
   • Cool compresses may provide symptomatic relief 2
   • Oatmeal baths may help relieve local symptoms 2

2. Systemic treatments:

   • For severe or widespread cases, systemic corticosteroids may be needed
   • Treatment duration should be at least 14 days to prevent return visits 3
   • Short-duration oral corticosteroid courses (less than 14 days) are associated with increased risk of return healthcare visits 3

Common Pitfalls to Avoid

1. Undertreatment:

   • Prescribing systemic steroids for less than 14 days increases the risk of return visits 3
   • Emergency clinicians often prescribe shorter courses than recommended 3

2. Ineffective interventions:

   • Over-the-counter antihistamines have uncertain usefulness for local symptom relief 2
   • Low-potency corticosteroids may not provide significant symptom improvement 2

When to Refer

Consider referral to a dermatologist or emergency department for:

• Severe or widespread dermatitis
• Facial or genital involvement
• Signs of secondary infection
• Systemic symptoms
• Failure to respond to initial treatment

By using the correct ICD-10 code (L23.7) and implementing appropriate treatment strategies, clinicians can effectively document and manage poison ivy dermatitis while minimizing the risk of treatment failure and return visits.