ICD-10 Coding for Leg Ulcer(I87.311, L97.423)
Complete ICD-10-CM coding and documentation guide for Leg Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Leg Ulcer
I83.0-I83.2Primary Range
Varicose veins of lower extremities with ulcer
Primary range for venous ulcers, often associated with varicose veins.
Non-pressure chronic ulcer of lower limb, not elsewhere classified
Used to specify the severity and location of non-pressure ulcers.
Type 2 diabetes mellitus with foot ulcer
Relevant for diabetic foot ulcers, indicating underlying diabetes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I87.311 | Chronic venous hypertension (idiopathic) with ulcer of right lower extremity | Use when venous hypertension is the primary cause of the ulcer. |
|
| L97.423 | Non-pressure chronic ulcer of left midfoot with necrosis of muscle | Use for non-pressure 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 venous leg ulcer
Essential facts and insights about Leg Ulcer
Primary ICD-10-CM Codes for leg ulcer
Decision Criteria
clinical Criteria
- Presence of venous reflux and edema
L97.423 - Non-pressure chronic ulcer of left midfoot with necrosis of muscle
Use for non-pressure ulcers with muscle necrosis.
Applicable To
- Diabetic foot ulcer with muscle necrosis
Excludes
- Pressure ulcer (L89.-)
Clinical Validation Requirements
- Biopsy-confirmed muscle necrosis
- Wagner Grade 3 or higher
Coding Notes
Document ulcer severity and underlying conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Leg Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I87.311.
Impact
Clinical: Loss of specific clinical information, Regulatory: Non-compliance with coding standards, Financial: Potential for reduced reimbursement
Mitigation Strategy
Use specific codes for ulcer severity and location
Impact
Reimbursement: Incorrect billing and potential claim denials, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data records
Mitigation Strategy
Always specify laterality using -LT or -RT modifiers.
Impact
Lack of detailed ulcer characteristics can lead to audit issues.
Mitigation Strategy
Implement standardized wound assessment forms.
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 Leg Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Leg Ulcer
Use these documentation templates to ensure complete and accurate documentation for Leg Ulcer. These templates include all required elements for proper coding and billing.
Venous ulcer assessment
Specialty: Wound CareRequired Elements
- Location and size of ulcer
- Presence of edema
- ABPI results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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