Wiki Ulcers on Healing Amputation Stumps

[KristaBrenholt]

Hello,

I've been asking around in my office but can't seem to get a straight answer. How do you code an ulcer forming in a healing amputation stump? Obviously, you want the L code for the ulcer, the Z code for the amputation status, E11.62- if applicable. Is there a T-code we should be using as well?

I see in other forums some folks say that ulcers are not complications of amputation stumps, so you shouldn't use T87.89 (other complications of amputation stump), but I can't find a primary source for that information. Alternatively, maybe L76.82 (Other postprocedural complications of skin and subcutaneous tissue)? However, I do have a patient who's ulcer is deep enough to affect the bone, so that seems wrong as well...

Any insight would be appreciated! Thanks!

 

[miriambroyles]

I would query the provider as to the cause of the ulcer... Is it pressure from a prosthetic? Is it diabetes affecting the healing of the amputation wound? Knowing the cause or type of ulcer will help with code selection. Also, if the provider says the ulcer is a complication of the amputation, then it is.

 

[KristaBrenholt]

I would query the provider as to the cause of the ulcer... Is it pressure from a prosthetic? Is it diabetes affecting the healing of the amputation wound? Knowing the cause or type of ulcer will help with code selection. Also, if the provider says the ulcer is a complication of the amputation, then it is.

So, in this case it is documented as "Diabetic ulcer of amputation surgical site" The amputation was of the great left toe. I code with E11.621, L97.526, Z89.412, and then that's where I'm lost. The doctor selected the T code for non-healing surgical site, but I believe complication of amputation stump is more accurate.

Additionally, what I'm not understanding is where other people have found information that you should NOT code it that way. One person in this tread here says that (https://www.aapc.com/discuss/threads/dx-for-pressure-ulcer-on-bka-stump.142582/) and then again here (https://medprohealthcaresolutions.w...stumped-over-coding-amputation-complications/). I can't find an actual, reliable, primary source though!