ICD-10 Coding for Osteomyelitis of Foot(M86.07, E11.69)
Complete ICD-10-CM coding and documentation guide for Osteomyelitis of Foot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Osteomyelitis of Foot
M86.0-M86.9Primary Range
Osteomyelitis
This range includes all types of osteomyelitis, with specific codes for the foot.
Bacterial and viral infectious agents
Used to identify the causative organism in osteomyelitis cases.
Type 2 diabetes mellitus with other specified complications
Used when osteomyelitis is documented as a complication of 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 |
|---|---|---|---|
| M86.07 | Acute hematogenous osteomyelitis, ankle and foot | Use when acute hematogenous osteomyelitis is confirmed in the foot. |
|
| E11.69 | Type 2 diabetes mellitus with other specified complication | Use when osteomyelitis is documented as a complication of diabetes. |
|
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 osteomyelitis of foot
Essential facts and insights about Osteomyelitis of Foot
Primary ICD-10-CM Codes for osteomyelitis of foot
Decision Criteria
clinical Criteria
- Acute symptoms and positive imaging findings
documentation Criteria
- Explicit mention of acute hematogenous osteomyelitis
Applicable To
- Acute osteomyelitis of the foot
Excludes
- Chronic osteomyelitis (M86.3-)
Clinical Validation Requirements
- MRI showing bone marrow edema
- Positive bone biopsy culture
Code-Specific Risks
- Misclassification as chronic if not specified
Coding Notes
- Ensure laterality and type are documented to avoid unspecified codes.
E11.69 - Type 2 diabetes mellitus with other specified complication
Use when osteomyelitis is documented as a complication of diabetes.
Applicable To
- Diabetic osteomyelitis
Excludes
- Diabetes without complication (E11.9)
Clinical Validation Requirements
- Documentation linking diabetes to osteomyelitis
Coding Notes
Ensure the causal relationship is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Methicillin susceptible Staphylococcus aureus as the cause of diseases classified elsewhere
B95.61Differential 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 Osteomyelitis of Foot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M86.07.
Impact
Clinical: Inadequate treatment targeting, Regulatory: Non-compliance with coding guidelines, Financial: Potential for reduced reimbursement
Mitigation Strategy
Ensure culture results are documented, Include organism codes when applicable
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies laterality and type of osteomyelitis.
Impact
Reimbursement: Incorrect sequencing affects DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient conditions.
Mitigation Strategy
Query the provider to confirm the relationship between diabetes and osteomyelitis.
Impact
Failure to document the causal relationship can lead to incorrect DRG assignment.
Mitigation Strategy
Ensure documentation clearly states the relationship between diabetes and osteomyelitis.
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 Osteomyelitis of Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Osteomyelitis of Foot
Use these documentation templates to ensure complete and accurate documentation for Osteomyelitis of Foot. These templates include all required elements for proper coding and billing.
Acute osteomyelitis in diabetic patient
Specialty: PodiatryRequired Elements
- Patient history
- Imaging results
- Lab findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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