ICD-10 Coding for Claudication(I70.213, E11.51)
Complete ICD-10-CM coding and documentation guide for Claudication. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Claudication
I70.2-I70.9Primary Range
Atherosclerosis of arteries
This range includes codes for atherosclerosis of extremities, which is a common cause of claudication.
Peripheral vascular disease, unspecified
Used when claudication is present without specific documentation of atherosclerosis.
Type 2 diabetes with diabetic peripheral angiopathy
Relevant when diabetes is present with peripheral angiopathy contributing to claudication.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I70.213 | Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs | Use when atherosclerosis is documented with claudication symptoms in bilateral legs. |
|
| E11.51 | Type 2 diabetes mellitus with diabetic peripheral angiopathy | Use when diabetes is present and contributes to peripheral vascular issues. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for claudication
Essential facts and insights about Claudication
Primary ICD-10-CM Codes for claudication
Decision Criteria
clinical Criteria
- Documented atherosclerosis with claudication symptoms.
coding Criteria
- Use I70.213 for bilateral leg involvement.
Applicable To
- Atherosclerosis with claudication
Excludes
- Neurogenic claudication
Clinical Validation Requirements
- Ankle-brachial index ≤0.9
- Doppler ultrasound showing >50% stenosis
Code-Specific Risks
- Incorrectly using I73.9 when atherosclerosis is documented.
Coding Notes
- Ensure laterality is documented for accurate coding.
E11.51 - Type 2 diabetes mellitus with diabetic peripheral angiopathy
Use when diabetes is present and contributes to peripheral vascular issues.
Applicable To
- Diabetes with peripheral vascular disease
Excludes
- Peripheral vascular disease without diabetes
Clinical Validation Requirements
- Diagnosis of diabetes with documented peripheral angiopathy
Coding Notes
Ensure diabetes is documented as contributing to the vascular condition.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Non-pressure ulcers
L97.-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Claudication to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I70.213.
Impact
Clinical: Inaccurate clinical records., Regulatory: Potential for coding audits., Financial: Delayed or denied claims.
Mitigation Strategy
Always document the side of the body affected.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Could result in coding audits., Data Quality: Impacts accuracy of clinical data.
Mitigation Strategy
Use I70.2- series codes with appropriate laterality.
Impact
Using unspecified codes like I73.9 without supporting documentation.
Mitigation Strategy
Ensure detailed documentation of atherosclerosis and symptoms.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Claudication, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Claudication
Use these documentation templates to ensure complete and accurate documentation for Claudication. These templates include all required elements for proper coding and billing.
Atherosclerosis with claudication
Specialty: CardiologyRequired Elements
- Site and laterality of atherosclerosis
- Symptoms and severity of claudication
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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