ICD-10 Coding for Right Foot Ulcer(L97.411, E11.621)
Complete ICD-10-CM coding and documentation guide for 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 Right Foot Ulcer
L97.4-L97.5Primary Range
Non-pressure chronic ulcer of lower limb, not elsewhere classified
This range includes codes for chronic ulcers of the right foot, specifying location and severity.
Type 2 diabetes mellitus with foot ulcer
Used as a primary code when the ulcer is due to 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 |
|---|---|---|---|
| L97.411 | Non-pressure chronic ulcer of right heel and midfoot limited to breakdown of skin | Use for non-pressure ulcers on the right heel or midfoot with skin breakdown. |
|
| E11.621 | Type 2 diabetes mellitus with foot ulcer | Use as a primary code when the ulcer is due to 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 right foot ulcer
Essential facts and insights about Right Foot Ulcer
Primary ICD-10-CM Codes for right foot ulcer
Decision Criteria
clinical Criteria
- Ulcer located on right heel or midfoot with skin breakdown
Applicable To
- Right heel ulcer
- Right midfoot ulcer
Excludes
- Pressure ulcer of right heel (L89.62-)
Clinical Validation Requirements
- Documentation of ulcer location on right heel or midfoot
- Evidence of skin breakdown
Code-Specific Risks
- Incorrectly coding as pressure ulcer
Coding Notes
- Ensure documentation specifies non-pressure ulcer.
E11.621 - Type 2 diabetes mellitus with foot ulcer
Use as a primary code when the ulcer is due to diabetes.
Applicable To
- Diabetic foot ulcer
Excludes
- Ulcer due to other causes
Clinical Validation Requirements
- Diagnosis of Type 2 diabetes
- Presence of foot ulcer
Coding Notes
Ensure diabetes is documented as the cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of insulin
Z79.4Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Foot Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L97.411.
Impact
Clinical: Lack of specificity can affect treatment decisions., Regulatory: May lead to audits and claim denials., Financial: Potential loss of reimbursement.
Mitigation Strategy
Always document specific ulcer characteristics, Avoid using unspecified codes
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on diabetes-related complications.
Mitigation Strategy
Always sequence E11.621 before L97.4- codes.
Impact
Incorrect sequencing of diabetes and ulcer codes.
Mitigation Strategy
Regular training on ICD-10 sequencing rules.
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 Right Foot Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Foot Ulcer
Use these documentation templates to ensure complete and accurate documentation for Right Foot Ulcer. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer management
Specialty: PodiatryRequired Elements
- Ulcer location
- Depth and severity
- Diabetes status
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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