ICD-10 Coding for Skin Substitute Graft Application(E11.621, L97.523, I83.013)
Complete ICD-10-CM coding and documentation guide for Skin Substitute Graft Application. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Skin Substitute Graft Application
E11-E14Primary Range
Diabetes mellitus
Diabetes-related ulcers often require skin grafts for treatment.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Chronic ulcers are common indications for skin graft procedures.
Varicose veins of lower extremities
Venous ulcers due to varicose veins may necessitate skin grafts.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.621 | Type 2 diabetes mellitus with foot ulcer | Use when a diabetic foot ulcer is present and requires a skin graft. |
|
| L97.523 | Non-pressure chronic ulcer of other part of left foot with necrosis of muscle | Use for chronic ulcers with muscle necrosis on the left foot. |
|
| I83.013 | Varicose veins of lower extremities with ulcer of thigh | Use for venous ulcers on the thigh due to varicose veins. |
|
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: convert CPT 15271 to ICD-10
Essential facts and insights about Skin Substitute Graft Application
Primary ICD-10-CM Codes for convert current procedural terminology 15271 to
Decision Criteria
clinical Criteria
- Presence of diabetic ulcer with specific HbA1c and ABI values.
Applicable To
- Diabetic foot ulcer
Excludes
- Pressure ulcers
Clinical Validation Requirements
- HbA1c <12%
- Pedal pulse/ABI ≥0.65
Code-Specific Risks
- Ensure HbA1c and ABI are documented.
Coding Notes
- Ensure comprehensive documentation of ulcer characteristics.
L97.523 - Non-pressure chronic ulcer of other part of left foot with necrosis of muscle
Use for chronic ulcers with muscle necrosis on the left foot.
Applicable To
- Chronic ulcer with muscle necrosis
Excludes
- Ulcers with bone involvement
Clinical Validation Requirements
- Wound measurements ≥1 cm² for ≥4 weeks
Coding Notes
Document wound characteristics and treatment history.
I83.013 - Varicose veins of lower extremities with ulcer of thigh
Use for venous ulcers on the thigh due to varicose veins.
Applicable To
- Venous stasis ulcer
Excludes
- Ulcers due to other causes
Clinical Validation Requirements
- Venous reflux studies
- Compression therapy history
Coding Notes
Ensure documentation of venous insufficiency and treatment.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of anticoagulants
Z79.01Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pressure ulcer of lower back
L89.5Non-pressure chronic ulcer of other part of left foot with necrosis of bone
L97.524Varicose veins of lower extremities with ulcer of calf
I83.012Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Skin Substitute Graft Application to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.621.
Impact
Clinical: Inadequate treatment documentation, Regulatory: Non-compliance with procedural standards, Financial: Potential claim denials
Mitigation Strategy
Always document the fixation method used, Include product details in notes
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate medical records.
Mitigation Strategy
Use CPT 15275 for facial applications.
Impact
High denial rate for missing ABI documentation.
Mitigation Strategy
Ensure ABI is measured and documented for all relevant cases.
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 Skin Substitute Graft Application, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Skin Substitute Graft Application
Use these documentation templates to ensure complete and accurate documentation for Skin Substitute Graft Application. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer requiring skin graft
Specialty: PodiatryRequired Elements
- Wound size and depth
- Ulcer location
- Previous treatment history
- Graft type and fixation method
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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