Wiki Foot/toe amputation

[warrenfamily103@gmail.com]

Good morning,

I have what may be a silly question. Provider documentation states an amputation of all five toes/mid foot on the right side. This would code as Z89.431 only, correct? There isn't an excludes note for the codes for the toes, Z89.411, Z89.421 but being part of the foot, I imagine they would not be coded individually? Like I said, maybe a silly question but asking anyway.

 

[Lunap99]

I would not code a trans-metatarsal amputation as the whole foot, only the toes. My logic being, when the patient comes back to have a callus or ulcer of the heel of the same foot treated, if you used the code for the whole foot, they wouldn't have a heel to be treated.
My question is whether to use both Z89.421 and Z89.411 or just Z89.421?