Home Health ICD-9/ICD-10 Alert

READER QUESTION:

It's OK To Repeat When Coding For Ulcers

Question: A patient has two pressure ulcers, one on her left heel and the other one on her right ankle. The one on the heel is the worse of the two. Can I report two 707.0x (Decubitus ulcer) codes for the same patient? The pressure ulcers are our primary focus of care, but she also has a stasis ulcer on her left calf. How should I code for this patient? 


Minnesota Subscriber

Answer: Yes, you may code the decubitus ulcer twice, if the fifth digits indicate two different locations, as is the case in your scenario.

On the other hand, if the patient had two decubiti, one on each heel, you would code 707.07 (Decubitus ulcer; heel) only once. There is no way to indicate that a condition is bilateral in ICD-9-CM.

Code for the stasis ulcer separately. If your patient has a stasis ulcer without additional information regarding varicosities or a history of deep vein thrombosis (DVT), you would code as below:

• M0230a: 707.07 (Decubitus ulcer; heel);

• M0240b: 707.06 (Decubitus ulcer; ankle);

• M0240c: 459.81 (Venous [peripheral] insufficiency, unspecified); and

• M0240d: 707.12 (Ulcer of calf).

Unless otherwise indicated, reader questions were answered by Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX.

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