Non pressure ulcer

[byronebrown@yahoo.com]

Hello,

I have a question from a physician who presented the following scenario:

The question is, if a providers sees a non-pressure ulcer and the muscle or bone is exposed, but does not appreciate any necrosis of either, then how is this coded? It is specified to be down to the bone, just not necrotic.

My response would be:
1. Ask physician for location/severity/laterality/causation of the non-pressure ulcer

2. Chp 13 guidelines "bone vs joint" state that the bone may be affected at the lower or upper end. Though portion of the bone may be affected at the joint, the site designation would be the bone. (Would this apply for pressure ulcers or just musculoskeletal / connective tissue diagnosis?)

3. Once I have all of the information documented, I would assign the appropriate code.

As is, the question to me is proposing that there is a "non-pressure ulcer of bone or muscle with unspecified severity" since the physician is documenting "specified to be down to the bone, ,just not necrotic."

Would a code from L97/L98 be appropriate?

Is this correct?

Thanks,

Byrone