ICD-10 Coding for Diabetic Right Foot Ulcer(E11.621, L97.413)
Complete ICD-10-CM coding and documentation guide for Diabetic Right Foot Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diabetic Right Foot Ulcer
E10.621-E11.621Primary Range
Diabetes with foot ulcer
Primary codes for diabetes with foot ulcer, specifying type and presence of ulcer.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Used to specify the location, laterality, and severity of the 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 presents with a foot ulcer. |
|
| L97.413 | Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle | Use for right heel 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 right foot ulcer
Essential facts and insights about Diabetic Right Foot Ulcer
Primary ICD-10-CM Codes for diabetic right foot ulcer
Decision Criteria
clinical Criteria
- Patient has Type 2 diabetes and a documented foot ulcer.
L97.413 - Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle
Use for right heel ulcers with muscle necrosis.
Applicable To
- Ulcer with muscle necrosis
Excludes
- Pressure ulcers
Clinical Validation Requirements
- Ulcer on right heel with muscle necrosis
- Documented depth and severity
Coding Notes
Document ulcer location, laterality, and severity.
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 Right 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: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the diabetes type and its complications.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces specificity and accuracy of medical records.
Mitigation Strategy
Specify ulcer severity and location to use specific codes like L97.413.
Impact
Using unspecified codes can trigger audits.
Mitigation Strategy
Ensure detailed documentation of ulcer characteristics.
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 Right Foot Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diabetic Right Foot Ulcer
Use these documentation templates to ensure complete and accurate documentation for Diabetic Right Foot Ulcer. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer with muscle necrosis
Specialty: EndocrinologyRequired Elements
- Ulcer location and severity
- Diabetes type and control status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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