ICD-10 Coding for Ulcer Left Foot(L97.423, E11.621)
Complete ICD-10-CM coding and documentation guide for Ulcer Left Foot. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ulcer Left Foot
L97.4-L97.5Primary Range
Non-pressure chronic ulcer of lower limb, not elsewhere classified
This range includes codes for non-pressure ulcers of the lower limb, specifically the left foot, which is the primary focus for coding left foot ulcers.
Type 2 diabetes mellitus with specified complications
This range is relevant for coding diabetic foot ulcers, which often occur in patients with type 2 diabetes.
Pressure ulcer of heel
This range is relevant for coding pressure ulcers, which must be differentiated from non-pressure ulcers.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| L97.423 | Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle | Use when the ulcer is located on the left heel or midfoot and involves necrosis of muscle. |
|
| E11.621 | Type 2 diabetes mellitus with foot ulcer | Use when a foot ulcer is present in a patient with type 2 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 left foot ulcer
Essential facts and insights about Ulcer Left Foot
Primary ICD-10-CM Codes for ulcer left foot
Decision Criteria
clinical Criteria
- Ulcer involves necrosis of muscle on left heel or midfoot
Applicable To
- Ulcer with necrosis of muscle
Excludes
- Pressure ulcer (L89.-)
Clinical Validation Requirements
- Documentation of ulcer location on left heel or midfoot
- Presence of necrosis involving muscle
Code-Specific Risks
- Incorrectly coding as pressure ulcer
Coding Notes
- Ensure documentation specifies non-pressure etiology and muscle necrosis.
E11.621 - Type 2 diabetes mellitus with foot ulcer
Use when a foot ulcer is present in a patient with type 2 diabetes.
Applicable To
- Diabetic foot ulcer
Excludes
- Diabetic peripheral angiopathy with gangrene (E11.52)
Clinical Validation Requirements
- Diagnosis of type 2 diabetes
- Presence of foot ulcer
Coding Notes
Sequence diabetes code first when coding diabetic foot ulcers.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Type 2 diabetes mellitus with foot ulcer
E11.621Differential 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 Ulcer Left Foot to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L97.423.
Impact
Clinical: Leads to inadequate treatment planning., Regulatory: Non-compliance with coding specificity requirements., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Always document laterality and specific site., Use templates to ensure comprehensive documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification affects compliance with coding guidelines., Data Quality: Impacts the accuracy of clinical data and statistics.
Mitigation Strategy
Ensure documentation specifies etiology to differentiate between pressure and non-pressure ulcers.
Impact
Lack of specificity in coding can lead to audit flags.
Mitigation Strategy
Use detailed documentation and coding templates to ensure specificity.
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 Ulcer Left Foot, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ulcer Left Foot
Use these documentation templates to ensure complete and accurate documentation for Ulcer Left Foot. These templates include all required elements for proper coding and billing.
Diabetic foot ulcer with necrosis
Specialty: PodiatryRequired Elements
- Ulcer location and size
- Depth and tissue involvement
- Diabetes status and control measures
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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