ICD-10 Coding for Right Foot Gangrene(E11.52, I70.261, I96)
Complete ICD-10-CM coding and documentation guide for Right Foot Gangrene. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Foot Gangrene
E11.5Primary Range
Type 2 diabetes mellitus with circulatory complications
Primary range for gangrene linked to diabetes.
Atherosclerosis of arteries of extremities
Used for gangrene due to atherosclerosis without diabetes.
Gangrene, not elsewhere classified
Used when gangrene is not linked to diabetes or atherosclerosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene | Use when gangrene is directly linked to diabetes. |
|
| I70.261 | Atherosclerosis of native arteries of extremities with gangrene, right leg | Use for non-diabetic ischemic gangrene. |
|
| I96 | Gangrene, not elsewhere classified | Use only if no causal link to diabetes or atherosclerosis. |
|
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 right foot gangrene
Essential facts and insights about Right Foot Gangrene
Primary ICD-10-CM Codes for right foot gangrene
Decision Criteria
clinical Criteria
- Presence of diabetes and peripheral angiopathy.
Applicable To
- Diabetic gangrene
Excludes
- Gangrene due to other causes
Clinical Validation Requirements
- HbA1c >7%
- Peripheral neuropathy
- PAD confirmed by ABI <0.9
Code-Specific Risks
- Incorrectly using when gangrene is not linked to diabetes.
Coding Notes
- Ensure documentation specifies diabetes as the cause of gangrene.
I70.261 - Atherosclerosis of native arteries of extremities with gangrene, right leg
Use for non-diabetic ischemic gangrene.
Applicable To
- Gangrene due to atherosclerosis
Excludes
- Diabetic gangrene
Clinical Validation Requirements
- Absent pedal pulses
- Angiography showing >70% occlusion
Coding Notes
Ensure documentation specifies atherosclerosis as the cause of gangrene.
I96 - Gangrene, not elsewhere classified
Use only if no causal link to diabetes or atherosclerosis.
Applicable To
- Gangrene not linked to diabetes or atherosclerosis
Excludes
- Diabetic gangrene
- Gangrene due to atherosclerosis
Clinical Validation Requirements
- Negative cultures
- No vascular insufficiency
Coding Notes
Use only when no specific cause is identified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
L97.5-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 Right Foot Gangrene to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.52.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the cause of gangrene., Use specific ICD-10 codes.
Impact
Reimbursement: Incorrect reimbursement due to misclassification., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data affecting clinical outcomes.
Mitigation Strategy
Replace with E11.52 when diabetes is documented.
Impact
Reimbursement: Potential claim denials due to lack of specificity., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Always specify 'right' or 'left' in documentation.
Impact
Using I96 without excluding diabetes or atherosclerosis.
Mitigation Strategy
Ensure documentation specifies the cause of gangrene.
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 Right Foot Gangrene, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Foot Gangrene
Use these documentation templates to ensure complete and accurate documentation for Right Foot Gangrene. These templates include all required elements for proper coding and billing.
Diabetes-Linked Gangrene
Specialty: PodiatryRequired Elements
- Patient history
- Physical examination findings
- Laboratory results
- Imaging studies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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