Wiki Coding Leukocytoclastic vasculitis

[driegel]

I have a question on the proper ICD-10 code when the multiple physicians note in their H&P, discharge summary and consults that the patient has Leukocytoclastic vasculitis due to Keflex. The patient had multiple skin lesions on both bilateral lower extremities. The patient also had a history of Peripheral vascular disease, DVT, urinary tract infection, and hypotension. The coders at my facility use the 3M coding tool and coded the primary diagnosis of I77.6- arteritis. The insurance carrier is telling us the more appropriate diagnosis code is L95.8 (vasculitis, limited to skin, other specified).

Our argument is that the patient had conditions not just limited to the skin, but also the Peripheral vascular disease with wounds secondary to vascular insufficiency. The patient did have a consult with a vascular surgeon and will follow up with him post discharge. Also had a DVT, UE. And peripheral neuropathy.

Any thoughts on what code is correct for the primary diagnosis?
Thanks
Deb

 

[moore42el]

I'm new to coding but have worked as a certified medical transcriptionist for 20+ years. I did a little research for your question and I came up with this: Keflex is the brand name for generic cephalexin which is the antibiotic that caused the vasculitis. Would this not be drug induced by the antibiotic? If so, the code should be T36.1X5, adverse effect of cephalosporins and other beta-lactam antibiotics.