Wiki Stasis Ulcer

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
G
Code: I87.2

Code Name: ICD-10 Code for Venous insufficiency (chronic) (peripheral)

Block: Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)

Details: Venous insufficiency (chronic) (peripheral)
Stasis dermatitis

Excludes 1:stasis dermatitis with varicose veins of lower extremities (I83.1-, I83.2-)

Guidelines: Diseases of the circulatory system (I00-I99)

Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
systemic connective tissue disorders (M30-M36)
transient cerebral ischemic attacks and related syndromes (G45.-)

For more details on I87.2, ICD-10 Code for Venous insufficiency (chronic) (peripheral) , visit: https://coder.aapc.com/icd-10-codes/

ancoleman22

Networker
Messages
62
Best answers
0
Can anybody tell me what the default code is for venous stasis ulcer? I work in home health and sometimes we get very little documentation. What code would you use if it just states "venous stasis ulcer" or "stasis ulcer" but doesn't mention venous insufficiency or varicose veins?

Thanks!
 

pamtienter

Expert
NAB Member
Messages
349
Location
Mound, MN
Best answers
0
In the Index under Ulcer, stasis (venous), it says to see Varix, leg, with ulcer, without varicose veins I87.2 (Venous insufficiency (chronic) (peripheral)).

Stasis ulcers are most likely caused by inadequate venous circulation in the area, so that is why it's classified this way. In addition to I87.2, you can also then code the appropriate L97.- code for site and severity of the ulcer.
 

ancoleman22

Networker
Messages
62
Best answers
0
See when I look at it, I see

stasis (venous)- see Varix, leg, with, ulcer
without varicose veins I87.2

I always just took the code to Varix, leg, with ulcer or the I83.0 group but are you saying that if nothing is specific then to take it to the Venous Ins. code?

So..unless stated that the patient has varicose veins then I should take it to I87.2?

I just want to make sure I am understanding correctly. Sometimes I start overthinking things and get myself all confused!

Thanks for all your help!
 

ancoleman22

Networker
Messages
62
Best answers
0
Ok so now I'm really confused...I'm reading over the guidelines and default codes. It states the default code is listed next to the main term so wouldn't the default code be the I83.0 if not stated as with or without varicose veins?
 
Messages
811
Best answers
0
You have to remember the indentations make a difference.

Ulcer is the main term
stasis (venous)- see Varix, leg, with, ulcer [this would be WITH varicose veins]
without varicose veins I87.2

It's telling you there's two options for stasis, with or without varicose veins. In this case, if you have stasis (venous), the word "See" directs you to the code you should be using; it's not a suggestion, it's a direction. "Varix" is a varicose vein, so it's saying you need to look under that term to find your code. If you have stasis without varicose veins, then you use I87.2 because there's no linkage to Varix.

If you then look under Varix, leg, with, ulcer it shows as

Varix (lower limb) (ruptured)
leg
with
ulcer
then there are several options as to indicate the site. In other words, you'd read this as a varicose vein(s), in the leg, with an ulcer... it's not an ulcer with a varicose vein, it's a varicose vein with an ulcer. (if you read this out loud it might make more sense.

Both of these codes are in a block of codes described as "Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified".
I87.2 is "Venous insufficiency (chronic) (peripheral)", not related to varicose veins.
I83.009 is "Varicose veins of unspecified lower extremity with ulcer of unspecified site". As previously mentioned, there's a direction "Use Additional code to identify severity of ulcer (L97.-)"

If the only information you have is "venous stasis ulcer", you need to look under the See look up because it's been defined by "venous". I83.009 describes varicose veins of an unspecified lower extremity with an ulcer with an unspecified site.

I83.0 requires a 5th character so that would not be a default code. You can choose from I83.00 (unspecified lower extremity), I83.01 (right lower), and I83.02 (left lower), but they all require a 6th character, so none of these would be default codes.

If there is no mention of varicose veins, then you wouldn't look under "Varix". Therefore you're left with only one option, I87.2.

Bottom line: You need to consider the etiology. That's where my statement "it's not an ulcer with a varicose vein, it's a varicose vein with an ulcer" comes into play.
 

ancoleman22

Networker
Messages
62
Best answers
0
Ok thank you!

I guess what is throwing me off is that there is a note in my book that states that venous insufficiency is normally not severe enough to cause a ulcer.

Also, it throws me off that there is no note to add an additional code for the ulcer.

It just had me thinking because almost every case I have coded is always taken to I87.2 and after reading the note again, I started to question if I was doing it correctly.
 
Last edited:
Messages
811
Best answers
0
I have troubles if I read too far into something. Needless to say, I talk to myself a lot :D If I say things out loud, I tend to understand what I'm looking at.
 
Top