Reactive perforating collagenosis

This code represents reactive perforating collagenosis, a rare, acquired or inherited dermatosis characterized by transepidermal elimination of altered collagen fibers. It presents as umbilicated papules or nodules, often with a central keratotic plug, typically on the extensor surfaces of the extremities and trunk. The condition is frequently associated with systemic diseases such as diabetes mellitus, chronic renal failure, or malignancy.

Assign this code when documentation clearly indicates a diagnosis of reactive perforating collagenosis. This diagnosis is typically established through clinical presentation and confirmed by skin biopsy demonstrating characteristic transepidermal elimination of collagen. It is crucial to link this diagnosis to any associated systemic conditions if present.

• Ensure the physician documentation explicitly states "reactive perforating collagenosis" or a similar definitive diagnosis.
• Always code any underlying systemic conditions (e.g., diabetes, chronic kidney disease) that are associated with the reactive perforating collagenosis, sequencing them appropriately.
• Differentiate from other perforating dermatoses like elastosis perforans serpiginosa or Kyrle's disease, which involve different eliminated dermal components.