Wiki neuropathic ulcer ICD-10

[stogsmom3]

Anyone have any advice how to code an ulcer documented as "Neuropathic Ulcer"? The note also states that the patient isn't diabetic. I code for Wound Care. I already know which L97.___ code to use. But, it is my understanding that the L97 codes aren't to be billed as primary. There must be a primary. In this case, it may be a lack of documentation on the provider. I don't know the cause of the neuropathy. But, when billing for the debridements the G62.9 and G90.09 aren't listed on the LCD. Anyone have any ideas?

Thanks
Melissa

 

[AlanPechacek]

Unfortunately, Neurogenic or Neuropathic Ulcer does not have a specific code, or Code Set. In the Alphabetic Index of Diseases, there is Ulcer>Skin which has the assortment of Synonyms (which I would interpret as "includes"): Atrophic, Chronic, Neurogenic, Non-healing, Perforating, Pyogenic, Trophic, Tropical, and directs to code L98.499: Non-pressure chronic ulcer of skin, "other site." However, since you have already designated a "site" by your L97. code, this L98.499 code would not apply. Therefore, stick with your L97. code.

As to the "Neuropathic" aspect, there is G62.9: Polyneuropathy, unspecified. Since your physician has not "specified" the type of or cause of the Neuropathy, this is all there is. This could be used with your ulcer code, even though it is "unspecified." I would try to get a "specific" diagnosis for the Neurologic Disease causing the Neuropathic Ulcer from your physician so as to get to the most specific code. (When in doubt, bug the Doc.)

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com

 

[AlanPechacek]

Unfortunately, Neurogenic or Neuropathic Ulcer does not have a specific code, or Code Set. In the Alphabetic Index of Diseases, there is Ulcer>Skin which has the assortment of Synonyms (which I would interpret as "includes"): Atrophic, Chronic, Neurogenic, Non-healing, Perforating, Pyogenic, Trophic, Tropical, and directs to code L98.499: Non-pressure chronic ulcer of skin, "other site." However, since you have already designated a "site" by your L97. code, this L98.499 code would not apply. Therefore, stick with your L97. code.

As to the "Neuropathic" aspect, there is G62.9: Polyneuropathy, unspecified. Since your physician has not "specified" the type of or cause of the Neuropathy, this is all there is. This could be used with your ulcer code, even though it is "unspecified." I would try to get a "specific" diagnosis for the Neurologic Disease causing the Neuropathic Ulcer from your physician so as to get to the most specific code. (When in doubt, bug the Doc.)

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com

P.S. I am not a "Guru."