ICD-10 Coding for Diabetic Foot Ulcer(E11.621, L97.423)
Complete ICD-10-CM coding and documentation guide for Diabetic Foot Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Foot Ulcer
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 documenting a foot ulcer in a patient with type 2 diabetes. |
|
| L97.423 | Non-pressure chronic ulcer of left midfoot with necrosis of muscle | Use to specify the location and severity of the ulcer. |
|
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 diabetic foot ulcer
Essential facts and insights about Diabetic Foot Ulcer
Primary ICD-10-CM Codes for diabetic foot ulcer
Decision Criteria
clinical Criteria
- Presence of a foot ulcer in a diabetic patient.
L97.423 - Non-pressure chronic ulcer of left midfoot with necrosis of muscle
Use to specify the location and severity of the ulcer.
Applicable To
- Ulcer with muscle necrosis
Excludes
- Ulcer due to pressure (L89.-)
Clinical Validation Requirements
- Documentation of ulcer location and depth
Coding Notes
Document ulcer specifics such as location, depth, and laterality.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of insulin
Z79.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetic Foot Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.621.
Impact
Clinical: May lead to inadequate treatment planning., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement.
Mitigation Strategy
Always document the relationship between diabetes and the ulcer.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces data specificity and quality.
Mitigation Strategy
Specify laterality and depth with codes like L97.522.
Impact
Risk of audits due to missing ulcer specifics such as depth and laterality.
Mitigation Strategy
Implement thorough documentation practices and regular training.
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 Diabetic Foot Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Foot Ulcer
Use these documentation templates to ensure complete and accurate documentation for Diabetic Foot Ulcer. These templates include all required elements for proper coding and billing.
Chronic Diabetic Foot Ulcer
Specialty: EndocrinologyRequired Elements
- Ulcer location
- Ulcer dimensions
- Depth of ulcer
- Presence of infection or necrosis
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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