What Diagnosis Code would you use for Claudication Leg Pain?

[lillianivy]

What Diagnosis Code would you use for Claudication Leg Pain? When you look up Claudication its the same code as PVD-443.9. I just think its not the correct code I am looking for. Help!!

[rhondatalley]

If the description is atherosclerosis with claudication (extremity), use 440.21. 729.5 for leg pain.

[lisammy]

If the doctor does not state claudication and nonvascular leg pain, you do not need to report 729.5. Claudication by definition is cramping and pain in the legs brought on by walking and releived with rest.

[preserene]

Yes 440.21 is the appropriate as she said.The terminology used often/ the physician definitely would add 'Intermittent' before claudication in these peripheral vascular diseases(PAD).
A little bit of brushing up about the desease, its terminology, the course of the disease and the related coding in ICD-9 would help us, I feel:
Intermittent Claudication-
People who have P.A.D. may have symptoms when walking or climbing stairs. These may include pain, numbness, aching, or heaviness in the leg muscles. Symptoms also may include cramping in the affected leg(s) and in the buttocks, thighs, calves, and feet. Symptoms may ease after resting.

These symptoms are called intermittent claudication (klaw-de-KA-shen). During physical activity, your muscles need increased blood flow. If your blood vessels are narrowed or blocked, your muscles won't get enough blood. When resting, the muscles need less blood flow, so the pain goes away.

About 10 percent of people who have P.A.D. have claudication. This symptom is more likely in people who also have atherosclerosis in other arteries.

In severe cases ,can go for pain at rest, ischemic ulceration may develop at the ends of toes and over the bony prominences on the affected feet..Gangrene may ensue putting the patient at risk of amputaion.

Now let us turn to the coding numbers in ICD-440.2 series- all the terminology or the descriptions are important to assign the code to the highest specificity because we should remember that the 5th digit relies on the further progress of the disease like rest with pain, ulceration and finally gangrene. Here if we look up at the beginning of the 440.2 "Use additional code to identify chronic total occlusion of artery of the extremities"
So when we code, for example, 440.3 it includes 440.21 and 440.22.

here, with our case of discussion, most probably, Claudication means intermittent claudication and it is vascular in origin. Intermittent claudication NOS also has their synonyms, like Charcots and so on.
Usually when the physician documents leg pain, he refers normally of neurological origin if he did not mention Intermittent Claudication.
But for benifit of doubt ,it alsways good to confirm with the doctor; he or she is the boss of documentation of the findings.
Thank you for reading!

[imomofbk56]

We had a issue where the indication for study was claudication but the test was negative. The diagnosis for claudication is 443.9 which is pvd. If test did not reveal pvd/pad but patient had study due to leg pain/claudication, is there not a different dx other than 443.9? If you use 729.5 it is not supported for the study. What to do????