ICD-10 Coding for Gangrene of Right Foot(E11.52, I70.261, I96)
Complete ICD-10-CM coding and documentation guide for Gangrene of Right Foot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gangrene of Right Foot
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene | Use when gangrene is directly linked to diabetic complications. |
|
| I70.261 | Atherosclerosis of native arteries of right leg with gangrene | Use when gangrene is due to peripheral artery disease without diabetes. |
|
| I96 | Gangrene, not elsewhere classified | Use when gangrene is not linked to diabetes or atherosclerosis. |
|
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 gangrene of right foot
Essential facts and insights about Gangrene of Right Foot
Primary ICD-10-CM Codes for gangrene of right foot
Decision Criteria
clinical Criteria
- Presence of diabetic complications with gangrene.
Applicable To
- Gangrene due to diabetes
Excludes
- Gangrene not due to diabetes
Clinical Validation Requirements
- HbA1c >7%
- Doppler/angiography showing arterial insufficiency
Code-Specific Risks
- Incorrectly using I96 for diabetic gangrene.
Coding Notes
- Ensure documentation links gangrene to diabetes.
I70.261 - Atherosclerosis of native arteries of right leg with gangrene
Use when gangrene is due to peripheral artery disease without diabetes.
Applicable To
- Gangrene due to peripheral artery disease
Excludes
- Gangrene due to diabetes
Clinical Validation Requirements
- ABI ≤0.5
- CT/MRA confirming atherosclerosis
Coding Notes
Ensure documentation specifies atherosclerosis as the cause.
I96 - Gangrene, not elsewhere classified
Use when gangrene is not linked to diabetes or atherosclerosis.
Applicable To
- Gangrene not due to diabetes or atherosclerosis
Excludes
- Gangrene due to diabetes
- Gangrene due to atherosclerosis
Clinical Validation Requirements
- Clinical evidence of gangrene without specific underlying cause
Coding Notes
Use only when other specific causes are ruled out.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Non-pressure chronic ulcer of lower limb
L97.5-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 Gangrene of Right Foot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.52.
Impact
Clinical: Leads to incomplete clinical picture., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Always document the etiology of gangrene., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect DRG assignment leading to potential revenue loss., Compliance: Violation of Excludes2 note., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E11.52 when gangrene is due to diabetes.
Impact
Improper sequencing of diabetes and gangrene codes.
Mitigation Strategy
Ensure E11.52 is sequenced before ulcer codes.
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 Gangrene of Right Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gangrene of Right Foot
Use these documentation templates to ensure complete and accurate documentation for Gangrene of Right Foot. These templates include all required elements for proper coding and billing.
Diabetic patient with gangrene of the right foot
Specialty: EndocrinologyRequired Elements
- Diabetes status
- Gangrene location and severity
- Underlying causes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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