ICD-10 Coding for Gangrene of the Right Foot(E11.52, I70.261, A48.0)
Complete ICD-10-CM coding and documentation guide for Gangrene of the 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 the Right Foot
E11.5-E11.59Primary Range
Type 2 diabetes mellitus with circulatory complications
Primary range for gangrene associated with diabetes mellitus.
Atherosclerosis of native arteries of extremities with gangrene
Used for gangrene due to atherosclerosis in non-diabetic patients.
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 related to diabetes mellitus. |
|
| I70.261 | Atherosclerosis of native arteries of extremities with gangrene, right leg | Use when gangrene is due to atherosclerosis in non-diabetic patients. |
|
| A48.0 | Gas gangrene | Use when gas gangrene is confirmed by culture. |
|
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 right foot
Essential facts and insights about Gangrene of the Right Foot
Primary ICD-10-CM Codes for gangrene right foot
Decision Criteria
clinical Criteria
- Presence of diabetic peripheral angiopathy with gangrene.
documentation Criteria
- Explicit documentation linking gangrene to diabetes.
Applicable To
- Diabetic gangrene
Excludes
- Gangrene not due to diabetes (I96)
Clinical Validation Requirements
- HbA1c >6.5%
- Ankle-Brachial Index <0.9
- CT angiography showing arterial occlusion
Code-Specific Risks
- Incorrectly using I96 when diabetes is present.
Coding Notes
- Ensure diabetes is documented as the cause of gangrene.
I70.261 - Atherosclerosis of native arteries of extremities with gangrene, right leg
Use when gangrene is due to atherosclerosis in non-diabetic patients.
Applicable To
- Gangrene due to peripheral vascular disease
Excludes
- Diabetic gangrene (E11.52)
Clinical Validation Requirements
- LDL >100 mg/dL
- Angiographic evidence of atherosclerosis
Coding Notes
Ensure atherosclerosis is documented as the cause of gangrene.
A48.0 - Gas gangrene
Use when gas gangrene is confirmed by culture.
Applicable To
- Clostridial myonecrosis
Excludes
- Non-gas gangrene (E11.52, I70.261)
Clinical Validation Requirements
- Positive Clostridium culture
- X-ray/CT showing subcutaneous emphysema
Coding Notes
Ensure gas gangrene is confirmed by laboratory culture.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
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 the 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: May lead to inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure documentation explicitly links diabetes to gangrene., Use templates to guide documentation.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: May trigger audits for incorrect coding., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Use E11.52 when gangrene is due to diabetes.
Impact
Using I96 instead of E11.52 for diabetic gangrene.
Mitigation Strategy
Ensure documentation clearly links gangrene to diabetes.
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 the Right Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gangrene of the Right Foot
Use these documentation templates to ensure complete and accurate documentation for Gangrene of the Right Foot. These templates include all required elements for proper coding and billing.
Diabetic patient with gangrene
Specialty: EndocrinologyRequired Elements
- History of diabetes
- Physical exam findings
- Imaging results
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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