What is the ICD (International Classification of Diseases) code for a non-pressure chronic ulcer of the skin of the left earlobe, possibly due to a complication of an ear piercing, in a patient with no implied past medical history?

ICD-10 Code for Skin Breakdown of Left Earlobe Hole

The appropriate ICD-10 code for skin breakdown of the left earlobe piercing site is L98.499 (Non-pressure chronic ulcer of skin of other sites with unspecified severity), as this captures a chronic skin defect at a non-standard anatomical location without pressure etiology. 1

Primary Coding Considerations

• L98.499 is the most accurate code when the earlobe breakdown represents a chronic, non-healing defect at the piercing site that doesn't fit other specific ulcer categories 1

• If the breakdown is acute and related to active infection, consider instead:

  • L08.9 (Local infection of skin and subcutaneous tissue, unspecified) for simple infected piercing 2
  • H61.10 (Unspecified noninfective disorder of pinna) if the primary issue is structural breakdown without infection 3

• If the breakdown is due to allergic contact dermatitis from nickel or other metals, use L23.0 (Allergic contact dermatitis due to metals), as nickel affects approximately 10% of women with pierced ears 3

Clinical Context That Influences Code Selection

• Timing matters for accurate coding: Most piercing complications occur within the first month, suggesting acute processes that may require infection codes rather than chronic ulcer codes 2

• Embedded jewelry causing tissue breakdown would be coded as T16.2 (Foreign body in ear) as the primary code, with L98.499 as secondary if chronic ulceration has developed 2, 4

• Keloid formation (occurring in 2.5% of ear piercings) should be coded as L91.0 (Keloid scar), not as an ulcer, since keloids represent excessive scar tissue rather than tissue breakdown 4, 5

Common Coding Pitfalls to Avoid

• Do not use pressure ulcer codes (L89.xxx series) for earlobe breakdown, as these are specifically for pressure-induced ulcers in immobile patients, not piercing-related complications 1

• Avoid using H60.xxx codes (otitis externa) unless there is canal involvement with inflammation, as simple earlobe breakdown doesn't involve the ear canal 3

• Don't default to "unspecified ear disorder" when a more specific skin/soft tissue code exists—the earlobe is skin and subcutaneous tissue, making dermatologic codes more appropriate than otologic codes 3, 6

Laterality Documentation

• While L98.499 doesn't specify laterality in the code itself, document "left earlobe" clearly in the clinical notes to support the diagnosis and ensure proper tracking of the specific site 7

• If your facility's coding system requires laterality specification, append modifier or use facility-specific documentation protocols to indicate left-sided involvement 7