Answer Porokeratosis

KStaten

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Hello Fellow Coders! :)

I have been researching the diagnosis of porokeratosis, in regards to podiatry coding, and would appreciate your input. :) I have seen this diagnosis pop up in reports often. However, the book directs us to Q82.8, Other congenital malformations of skin. A quick Google search of that word will direct you to definitions that emphasize that it is a rare, congenital disorder, with one statistic (accuracy unknown) claiming that it only affects less that 200,000 Americans. (Considering the US population is estimated to be over 330 million, that does seem to, in fact be, a very small percentage of the population.)

I have read other podiatry articles claiming that that term is readily accepted / used among the podiatry community, but that it is perhaps used interchangeably, and, according to some sources, admittedly in error. (?) I am inexperienced in podiatry coding (and podiatry terms, for that matter), which is why I am asking the experts. ;) Is this a diagnosis that anyone else sees often, as well? If so, does it take on a podiatry-specific definition that does not fall into the "rare, congenital disorder," as it is used elsewhere? If not, then is there a more appropriate diagnosis?

Thanks! :)
 

fltbaroque

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I'm no expert by any means, but I can tell you what my research has led me to!
I've struggled with this one also because there is never anything to indicate that the condition is congenital. I've seen different websites offer different suggestions. Some podiatry sites suggest L74.8 Other eccrine sweat disorders (poro- for a pore or duct). Acquired keratosis palmaris et plantaris is L85.1, which makes more sense to me, as Q82.8 is inherited keratosis palmaris et plantaris.
I would also be interested to know opinions of others that work in podiatry.
 

KStaten

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Thank you for your replies! :) I agree with you both and think that it should definitely not be coded as the congenital codes. I am wondering from a documentation standpoint, however, if simply the term "porokeratosis" is acceptable for us to make that assumption. It appears as though podiatrists may be using that term in a context where this is "to be assumed," but, from our training, we are pretty limited in the extent to which we are allowed to assume. Perhaps this is an area where podiatrists need to be more specific in documentation... or perhaps I am overthinking it.

As always, thank you all! I am always interested in hearing others' thoughts!
 
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