ICD-10 Coding for Diabetic Foot Wound(E11.621, L97.423)
Complete ICD-10-CM coding and documentation guide for Diabetic Foot Wound. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Foot Wound
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 foot ulcer is directly linked to Type 2 diabetes. |
|
| L97.423 | Non-pressure chronic ulcer of left midfoot with necrosis of muscle | Use for left midfoot ulcers with muscle necrosis. |
|
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 wound
Essential facts and insights about Diabetic Foot Wound
Primary ICD-10-CM Codes for diabetic foot wound
Decision Criteria
clinical Criteria
- Presence of a foot ulcer in a diabetic patient
Applicable To
- Diabetic foot ulcer
Excludes
- Atherosclerotic ulcer (I70.23-)
L97.423 - Non-pressure chronic ulcer of left midfoot with necrosis of muscle
Use for left midfoot ulcers with muscle necrosis.
Applicable To
- Ulcer with muscle necrosis
Excludes
- Pressure ulcer (L89.-)
Clinical Validation Requirements
- Documentation of ulcer location and depth
- Imaging or clinical evidence of muscle necrosis
Coding Notes
Ensure documentation specifies necrosis depth.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diabetic Foot Wound to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.621.
Impact
Clinical: Misrepresents patient's current condition., Regulatory: May lead to incorrect coding., Financial: Potential for claim denials.
Mitigation Strategy
Use 'healing' to describe ulcers still under treatment.
Impact
Reimbursement: May lead to claim denials or reduced payments., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of patient records.
Mitigation Strategy
Always document and code the specific side of the body.
Impact
Using unspecified codes increases audit risk.
Mitigation Strategy
Always document and code specific laterality.
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 Diabetic Foot Wound, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Foot Wound
Use these documentation templates to ensure complete and accurate documentation for Diabetic Foot Wound. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer with muscle necrosis
Specialty: PodiatryRequired Elements
- Location and dimensions of ulcer
- Depth and necrosis details
- Vascular and neurological status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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