ICD-10 Coding for Venous Insufficiency Ulcer(I87.2, L97.322)
Complete ICD-10-CM coding and documentation guide for Venous Insufficiency Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Venous Insufficiency Ulcer
I87.2Primary Range
Chronic venous insufficiency (CVI) of the lower extremities
Primary code for chronic venous insufficiency, used when ulcers are present.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Used to specify the location, depth, and severity of the ulcer.
Varicose veins of lower extremities with ulcer
Used when varicose veins are present with an 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 |
|---|---|---|---|
| I87.2 | Chronic venous insufficiency (CVI) of the lower extremities | Use when chronic venous insufficiency is the underlying cause of the ulcer. |
|
| L97.322 | Non-pressure chronic ulcer of left ankle with fat layer exposed | Use to specify ulcer location and depth when fat layer is exposed. |
|
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 venous insufficiency ulcer
Essential facts and insights about Venous Insufficiency Ulcer
Primary ICD-10-CM Codes for venous insufficiency ulcer
Decision Criteria
clinical Criteria
- Presence of venous reflux confirmed by Doppler
Applicable To
- Chronic venous hypertension
Excludes
- Varicose veins with ulcer (I83.2-)
Clinical Validation Requirements
- Doppler ultrasound showing venous reflux >0.5 sec
Code-Specific Risks
- Incorrect sequencing with ulcer codes
Coding Notes
- Always sequence I87.2 first when venous insufficiency is the underlying cause.
L97.322 - Non-pressure chronic ulcer of left ankle with fat layer exposed
Use to specify ulcer location and depth when fat layer is exposed.
Applicable To
- Ulcer with fat layer exposed
Excludes
- Pressure ulcer of ankle (L89.-)
Clinical Validation Requirements
- Wound assessment showing fat layer exposure
Coding Notes
Ensure documentation specifies depth and laterality.
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 Venous Insufficiency Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I87.2.
Impact
Clinical: Ambiguity in treatment planning, Regulatory: Non-compliance with ICD-10 requirements, Financial: Potential claim denials
Mitigation Strategy
Always specify right or left in documentation
Impact
Reimbursement: May lead to claim denials, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Always code I87.2 before L97.x when CVI is the cause.
Impact
Failure to sequence I87.2 before L97.x
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Venous Insufficiency Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Venous Insufficiency Ulcer
Use these documentation templates to ensure complete and accurate documentation for Venous Insufficiency Ulcer. These templates include all required elements for proper coding and billing.
Chronic venous insufficiency with ulcer
Specialty: Vascular SurgeryRequired Elements
- Ulcer location
- Ulcer depth
- Etiology
- Doppler ultrasound results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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