ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 L12.8

Billable / Specific CC

Other pemphigoid

L12
Block
0
Synonyms
151
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM L12.8

ICD-10-CM code L12.8 represents Other pemphigoid. This is a billable/specific code in the Skin and Subcutaneous Tissue chapter (block L12). The 2026 edition of ICD-10-CM L12.8 became effective on October 1, 2025.

Coding Tips for L12.8

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

L12.8 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Other pemphigoid. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for L12.8

Local Coverage Determinations (LCDs) from CMS MACs that list L12.8 as a covered diagnosis.

151 LCDs

Showing top 10 of 151 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1459 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1573 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1552 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1566 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1557 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J0840 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1571 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT 90376 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1560 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1572 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing L12.8.

14 policies

5 Medicare

Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
Policy ID: ART-54641
Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
Policy ID: ART-54643
Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
Policy ID: ART-55639
Billing and Coding: Intravenous Immunoglobulin (IVIG)
Policy ID: ART-56718
Billing and Coding: Intravenous Immune Globulin
Policy ID: ART-56779

1 Aetna

Parenteral Immunoglobulins
Policy ID: CPB-0206

CPT Codes Commonly Billed with L12.8

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for L12.8

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert L12.8 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
L12.8 6945 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 L12.8, Billing FAQ

Is ICD-10 code L12.8 billable? +

Yes, L12.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is L12.8 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does L12.8 map to? +

Per CMS GEMs, L12.8 maps to ICD-9 codes: 6945. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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