ICD-10 Coding for Diabetic Peripheral Vascular Disease(E11.51, E11.52)
Complete ICD-10-CM coding and documentation guide for Diabetic Peripheral Vascular Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Peripheral Vascular Disease
E08-E13Primary Range
Diabetes mellitus
This range includes codes for diabetes mellitus with various complications, including peripheral angiopathy.
Diseases of arteries, arterioles, and capillaries
This range includes codes for peripheral vascular diseases that may be used in conjunction with diabetes codes when specified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.51 | Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene | Use when the patient has Type 2 diabetes with peripheral vascular disease but no gangrene. |
|
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene | Use when the patient has Type 2 diabetes with peripheral vascular disease and gangrene. |
|
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 peripheral vascular disease
Essential facts and insights about Diabetic Peripheral Vascular Disease
Primary ICD-10-CM Codes for diabetic peripheral vascular disease
Decision Criteria
clinical Criteria
- Presence of diabetes with documented peripheral angiopathy
coding Criteria
- Do not code I73.9 with E11.51
Applicable To
- Diabetic peripheral vascular disease without gangrene
Excludes
- Peripheral vascular disease NOS (I73.9)
Clinical Validation Requirements
- Documentation of Type 2 diabetes with peripheral angiopathy
- ABI ≤0.9 indicating PVD
Code-Specific Risks
- Incorrectly coding with I73.9 when E11.51 should be used
Coding Notes
- Ensure documentation specifies the relationship between diabetes and PVD.
E11.52 - Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
Use when the patient has Type 2 diabetes with peripheral vascular disease and gangrene.
Applicable To
- Diabetic gangrene
Excludes
- Gangrene NOS (I96)
Clinical Validation Requirements
- Documentation of gangrene in a diabetic patient
- ABI <0.4 indicating severe PVD
Coding Notes
Ensure gangrene is documented with anatomical site and severity.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetic Peripheral Vascular Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.51.
Impact
Clinical: Misrepresentation of the patient's condition., Regulatory: Potential audit issues., Financial: Possible claim denials.
Mitigation Strategy
Ensure documentation specifies 'diabetic PVD'., Educate providers on the importance of specificity.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E11.51 alone when PVD is related to diabetes.
Impact
Using I73.9 instead of E11.51 for diabetic-related PVD.
Mitigation Strategy
Educate coders on the correct use of E11.51.
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 Peripheral Vascular Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Peripheral Vascular Disease
Use these documentation templates to ensure complete and accurate documentation for Diabetic Peripheral Vascular Disease. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer
Specialty: EndocrinologyRequired Elements
- Type of diabetes
- Presence of peripheral angiopathy
- Ulcer location and severity
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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