ICD-10 Coding for Venous Ulcer(I87.2, L97.829)
Complete ICD-10-CM coding and documentation guide for Venous Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Venous Ulcer
I87.2-I87.9Primary Range
Other disorders of veins and lymphatics
Includes chronic venous insufficiency and related ulcers.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Used to specify the location and severity of the ulcer.
Type 2 diabetes mellitus with circulatory complications
Used when venous ulcers are associated with diabetes.
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) (peripheral) | When chronic venous insufficiency is confirmed and associated with an ulcer. |
|
| L97.829 | Non-pressure chronic ulcer of other part of left lower leg | To specify the location and severity of a non-pressure ulcer on the left lower leg. |
|
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 ulcer
Essential facts and insights about Venous Ulcer
Primary ICD-10-CM Codes for venous ulcer
Decision Criteria
clinical Criteria
- Confirmed venous insufficiency with ulcer
Applicable To
- Chronic venous hypertension with ulcer
Excludes
- Varicose veins of lower extremities with ulcer (I83.0-)
Clinical Validation Requirements
- Duplex ultrasound showing venous reflux
- ABI ≥0.8 to rule out arterial disease
Code-Specific Risks
- Incorrectly coding as arterial ulcer
- Omitting duplex ultrasound documentation
Coding Notes
- Ensure documentation includes etiology and ulcer characteristics.
L97.829 - Non-pressure chronic ulcer of other part of left lower leg
To specify the location and severity of a non-pressure ulcer on the left lower leg.
Applicable To
- Ulcer of left lower leg
Excludes
- Pressure ulcer of lower leg (L89.-)
Clinical Validation Requirements
- Ulcer location and size documented
- Tissue type and depth described
Coding Notes
Ensure ulcer characteristics are fully documented.
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
L97.8-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Venous 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: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Review documentation for laterality and specific details., Use specific codes like I87.311 for right leg ulcers.
Impact
Reimbursement: May result in claim denials or reduced payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always pair I87.2 with an appropriate L97.x code.
Impact
Lack of detailed ulcer characteristics can lead to audit issues.
Mitigation Strategy
Ensure all ulcer details are documented thoroughly.
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 Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Venous Ulcer
Use these documentation templates to ensure complete and accurate documentation for Venous Ulcer. These templates include all required elements for proper coding and billing.
Venous Ulcer in Home Health
Specialty: Home HealthRequired Elements
- Ulcer location and size
- Tissue type and depth
- Vascular studies results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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