Venous Stasis Ulcer-Note does not specify if varicose veins present

LuckyLily

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Local Chapter Officer
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If there is a statement of 'venous stasis ulcer' how would this be coded. I've always gone with, Ulcer, stasis, 'see' varix, leg, with, ulcer. However I've been guided that since the note does not specifically document that the patient has varicose veins, I cannot use the I83.0-- but have to use I87.2-Venous insufficiency.

Wouldn't the documentation have to state 'without varicose veins' in some fashion in order to code this way.

There is a coding clinic 1991, 2Q, pg 20 that references that there has to be mention of varicose veins, but that was many years ago and ICD-9 did not have the same 'see' guideline after Ulcer, Stasis like ICD-10 does.

Are there any sources that have gone over this topic for ICD-10 and the proper way to look it up in the Alpha Index?

Thank you
 
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