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707.13: Ulcer of ankle

  1. #1
    Default 707.13: Ulcer of ankle
    Medical Coding Books
    I have a question regarding the indications of a skin substitute (Dermagraft) and if 707.13 is appropriate to use. Per its FDA indications, Dermagraft is to be used for diabetic foot ulcers (DFUs).

    Since 707.13 (ulcer of ankle) is listed in most Medicare LCDs as covered when billed with Dermagraft (HCPCS Q4106) and its application (CPT 15365), would the ankle then be considered part of the foot? Or, would 707.13 truly be an off-label diagnosis that so happens to be covered by many Medicare carriers?

    Thanks in advance for any input!


  2. Default
    Priority for the said procedure-
    Ulcer of toe
    Ulcer of foot

  3. #3
    My experience with commercial insurance will only pay for 707.13 and 707.14 if they don't deny it as experimental.
    Tammy Hulsey-Ferguson, CPC
    Past President AAPC Wichita, KS Local Chapter

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