ICD-10 Coding for Foot Ulcer(E10.621, E11.621, L97.4-)
Complete ICD-10-CM coding and documentation guide for Foot Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Foot Ulcer
E10.621-E11.621Primary Range
Diabetes with foot ulcer
Primary codes for diabetic foot ulcers, indicating the presence of a foot ulcer in patients with diabetes.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Used to specify the location and severity of the ulcer on the foot.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E10.621 | Type 1 diabetes mellitus with foot ulcer | Use when a patient with type 1 diabetes has a documented foot ulcer. |
|
| E11.621 | Type 2 diabetes mellitus with foot ulcer | Use when a patient with type 2 diabetes has a documented foot ulcer. |
|
| L97.4- | Non-pressure chronic ulcer of heel and midfoot | Use to specify the location of a foot ulcer on the heel or midfoot. |
|
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 Foot Ulcer
Primary ICD-10-CM Codes for foot ulcer
Decision Criteria
clinical Criteria
- Presence of type 1 diabetes and foot ulcer
Applicable To
- Diabetic foot ulcer in type 1 diabetes
Excludes
- Pressure ulcer
- Arterial ulcer
Clinical Validation Requirements
- Documented diagnosis of type 1 diabetes
- Presence of a foot ulcer
Code-Specific Risks
- Incorrect sequencing with L97 codes
Coding Notes
- Ensure diabetes code is sequenced before ulcer location codes.
E11.621 - Type 2 diabetes mellitus with foot ulcer
Use when a patient with type 2 diabetes has a documented foot ulcer.
Applicable To
- Diabetic foot ulcer in type 2 diabetes
Excludes
- Pressure ulcer
- Arterial ulcer
Clinical Validation Requirements
- Documented diagnosis of type 2 diabetes
- Presence of a foot ulcer
Coding Notes
Ensure diabetes code is sequenced before ulcer location codes.
L97.4- - Non-pressure chronic ulcer of heel and midfoot
Use to specify the location of a foot ulcer on the heel or midfoot.
Applicable To
- Chronic ulcer of heel
- Chronic ulcer of midfoot
Excludes
- Pressure ulcer
- Diabetic ulcer without specification
Clinical Validation Requirements
- Documentation of ulcer location and severity
Coding Notes
Specify laterality and severity for accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of insulin
Z79.4Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pressure ulcer
L89.-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Foot Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E10.621.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify left or right in documentation.
Impact
Reimbursement: Higher denial rates and potential revenue loss., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Document ulcer depth and use specific codes like L97.422.
Impact
Use of unspecified codes increases audit risk.
Mitigation Strategy
Ensure detailed documentation of ulcer characteristics.
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 Foot Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Foot Ulcer
Use these documentation templates to ensure complete and accurate documentation for Foot Ulcer. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer with neuropathy
Specialty: EndocrinologyRequired Elements
- Ulcer location
- Ulcer dimensions
- Depth and severity
- Neuropathy presence
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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