Current RMA Instruments:

Changes from Previous Instruments:

SOP Bulletin 136

ICD Coding:

• ICD-9-CM Codes: 701.0, 701.9
• ICD-10-AM Codes: L94.0, L94.1

This is a skin disorder in which there are localised areas of hardened skin.

This condition can occur alone, or as part of the wider disease process of systemic sclerosis/scleroderma. In the latter case, the SOP for systemic sclerosis should be applied instead of this SOP (see further comments, below).

Is specific diagnostic evidence required to apply the SOP? – Yes.

This diagnosis should be made by a dermatologist.

Are there sub-factors that require specific information? – No.

Additional diagnoses covered by SOP

• Circumscribed scleroderma
• Linear scleroderma
• Localised scleroderma
• Morphea

Conditions excluded from SOP

• Systemic sclerosis (ICD-9 710.11; ICD-10 M34.0) (SOP)
• Systemic scleroderma (ICD-9 710.11; ICD-10 M34.0) (SOP)
• CREST syndrome (ICD-9 710.12; ICD-10 M34.1) (SOP – Systemic Sclerosis)

Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

1. seek medical officer advice about further investigation, or;
2. generate a diagnostic report, or;
3. re-encode the condition, if appropriate.

Comments

There may be circumstances where the veteran was correctly diagnosed with localised sclerosis and then, with the efflux of time and the development of further systemic manifestation, also correctly diagnosed as systemic sclerosis.  In this situation, the original diagnosis is no longer valid, having been replaced by the systemic sclerosis diagnosis.  As such the new condition will need to be re-determined using the SOP for systemic sclerosis.