Allergic contact dermatitis due to metals

This code signifies an inflammatory skin reaction resulting from direct skin contact with specific metals, to which the individual has developed an allergic hypersensitivity. It presents as an eczematous rash, often pruritic, erythematous, and sometimes vesicular, localized to the area of contact with the metallic allergen. This is a delayed-type hypersensitivity reaction, not an immediate anaphylactic response.

Apply this code when documentation clearly indicates a diagnosis of allergic contact dermatitis where the causative agent is identified as a metal (e.g., nickel, cobalt, chromium). Common scenarios include reactions to jewelry, belt buckles, watchbands, or metallic components in clothing. Physician notes should specify "allergic contact dermatitis" and explicitly link it to metal exposure.

• Ensure the documentation specifies "allergic" contact dermatitis, not just "irritant" contact dermatitis, as these have different codes.
• Do not use this code if the reaction is due to non-metallic substances; refer to other L23.x codes.
• Always sequence this code as the primary diagnosis if it is the reason for the encounter, or as a secondary diagnosis if it's a co-morbidity being managed.