2027 ICD-10-CM Diagnosis Code L10.1Pemphigus vegetans
ICD-10-CM Codes›L00–L99›L10-L14›L10
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 387
- Chronic Condition
L10.1 is a billable ICD-10-CM diagnosis code for pemphigus vegetans. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 595 through 596. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 21 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified inflammatory condition of skin.
For Medicare Advantage risk adjustment, L10.1 maps to CMS-HCC Category 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders) under the V28 model, adding a risk factor of about 0.406 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
L10.1 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Pemphigus vegetans
- Pemphigus vegetans of Hallopeau type
- Pemphigus vegetans of Neumann type
- Pemphigus vulgaris
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to L10.1: its own notes plus those printed at L10, block L10-L14, and Chapter 12. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- lipomelanotic reticulosis (I89.8)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- viral warts (B07.-)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Pemphigus
group of chronic blistering diseases characterized histologically by acantholysis and blister formation within the epidermis.
Patient EducationClinical
Pemphigus
Pemphigus is an autoimmune disorder. If you have it, your immune system attacks healthy cells in your skin and mouth, causing blisters and sores. No one knows the cause. Pemphigus does not spread from person to person. It does not appear to be inherited. But some people's genes put them more at risk for pemphigus.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert L10.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About L10.1Overview
What is the ICD-10 code for pemphigus vegetans?
The ICD-10-CM code for pemphigus vegetans is L10.1 (sometimes written as L101). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is L10.1 (Pemphigus) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pemphigus vegetans on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does L10.1 group to?
When pemphigus vegetans is the principal diagnosis on an inpatient stay, it groups to MS-DRG 596, 595, with relative weights from 1.1067 to 2.0230 depending on complications. Higher weights mean higher Medicare reimbursement.
Is L10.1 a CC or MCC?
CMS lists L10.1 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 21 closely related codes in its exclusion list.
Can L10.1 be reported with L01.03?
Not as a rule. The Excludes1 note at L10, which applies to L10.1, lists "pemphigus neonatorum (L01.03)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is L10.1?
L10.1 (pemphigus vegetans) maps to CMS-HCC Category 387 (Pemphigus, Pemphigoid, and Other Specified Autoimmune Skin Disorders), commonly written as HCC 387, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. In the Part D prescription drug model it maps to RxHCC 314.
Does L10.1 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, L10.1 adds a risk adjustment factor of about 0.406 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.125 to 0.658 depending on the payment segment). HCC 387 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 387 category page.
