ICD-10 Coding for Diabetes with Foot Ulcer(E11.621, L97.4-)
Complete ICD-10-CM coding and documentation guide for Diabetes with Foot Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetes with Foot 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 |
|---|---|---|---|
| E11.621 | Type 2 diabetes mellitus with foot ulcer | Use when a patient with type 2 diabetes has a foot ulcer. |
|
| L97.4- | Non-pressure chronic ulcer of heel and midfoot | Use to specify the location of a diabetic foot ulcer. |
|
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: How do you code diabetes with a foot ulcer?
Essential facts and insights about Diabetes with Foot Ulcer
Primary ICD-10-CM Codes for diabetes with foot ulcer
Decision Criteria
clinical Criteria
- Presence of diabetes and a foot ulcer
Applicable To
- Diabetic foot ulcer
Excludes
- Pressure ulcer (L89.-)
Clinical Validation Requirements
- Documentation of diabetes mellitus
- Presence of a foot ulcer
Code-Specific Risks
- Ensure ulcer is related to diabetes and not a pressure ulcer.
Coding Notes
- Ensure documentation specifies the ulcer's location and severity.
L97.4- - Non-pressure chronic ulcer of heel and midfoot
Use to specify the location of a diabetic foot ulcer.
Applicable To
- Ulcer of heel
- Ulcer of midfoot
Excludes
- Pressure ulcer (L89.-)
Clinical Validation Requirements
- Documentation of ulcer location on heel or midfoot
Coding Notes
Use with a diabetes code to fully describe the condition.
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 Diabetes with Foot Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.621.
Impact
Clinical: Inadequate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Train staff on documentation standards., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Failure to comply with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always include a code from L97.- to specify the ulcer's location.
Impact
Missing details on ulcer severity and location.
Mitigation Strategy
Implement regular documentation audits.
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 Diabetes with Foot Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetes with Foot Ulcer
Use these documentation templates to ensure complete and accurate documentation for Diabetes with Foot Ulcer. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer in a patient with type 2 diabetes
Specialty: PodiatryRequired Elements
- Ulcer location and severity
- Diabetes management details
- Infection status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Diabetes with Foot Ulcer? Ask your questions below.