Wiki Coding Ulcers

Create Wiki Sort by date
W

warrenfamily103@gmail.com

Networker
Messages
83
Location
Largo, FL
Best answers
0
Good morning,

I am hoping to get some advice on coding for Ulcers. One specific scenario I am working on is where documentation says multiple non healing ulcerative wounds on right breast and back. She stated there was no purulence or warmth but noted background erythema. Does this give me enough information to assign a stage? Or does the provider need to specifically state a stage? Or specifically state that it is limited to breakdown of skin, etc... As it stands, would code choice L98.429 and N61.1 be correct? This has always confused me. I appreciate any feedback.
 
0
Is this a pressure ulcer or a non-pressure ulcer? By the looks of your codes without referring to my book at the moment, it looks like a non-pressure ulcer but just wanted to double-check.
 
0
The documentation doesn’t specifically say. I looked up ulcer, ulcerated, ulcerating, ulceration, ulcerative then down to back and the default code was L98.429 (unspecified severity) and breast is N61.1
 
0
Let me look at my book quick because coding pressure ulcers and non-pressure ulcers is a bit different, but being on the breast doesn't scream pressure ulcer to me. From the documentation, it seems you can back up your code with limited skin breakdown. In our guidelines, Chapter 12, Section b.2 says "Code based on documentation in the medical record. If the documentation does not provide information about the severity of the healing nonpressure ulcer, assign the appropriate code for unspecified severity". So, I do not think the doctors need to put word for word the code name, but they need to describe the ulcers. By your doctor describing it as only erythema around the skin, it seems that would be enough to back up the limited breakdown of the skin but nothing above that.

Here is a website I found that may help you out. This website does say unspecified severity should really be used.
 
0
kpeterson15 said:
Let me look at my book quick because coding pressure ulcers and non-pressure ulcers is a bit different, but being on the breast doesn't scream pressure ulcer to me. From the documentation, it seems you can back up your code with limited skin breakdown. In our guidelines, Chapter 12, Section b.2 says "Code based on documentation in the medical record. If the documentation does not provide information about the severity of the healing nonpressure ulcer, assign the appropriate code for unspecified severity". So, I do not think the doctors need to put word for word the code name, but they need to describe the ulcers. By your doctor describing it as only erythema around the skin, it seems that would be enough to back up the limited breakdown of the skin but nothing above that.

Here is a website I found that may help you out. This website does say unspecified severity should really be used.
Click to expand...
This was a very helpful website. I am still having a little difficulty with understanding the difference in ulcers. This is from one of my physicians note.

He has two neuropathic pressure ulcerations at the lateral aspect of the fibula. He has insufficiency ulceration, stage 3, at the anterior aspect of the right ankle.

Would the first be coded with an L89- and the second with an I83- and L97- codes?
 
You must log in or register to reply here.
Top