Non-Pressure Chronic Ulcers in ICD-10-CM
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1 Non-Pressure Chronic Ulcers in ICD-10-CM The coding and documentation of non-pressure chronic ulcers has greatly expanded in ICD-10-CM. The codes are located in categories L97 and L98. In order for the most appropriate code to be assigned at the highest level of specificity, documentation must include site, laterality, and severity. There are instructional notes for the codes that state to code first and associated underlying conditions, such as: any associated gangrene (I96) atherosclerosis of the lower extremities(i70.23-, I70.24-, I70.33-, I70.34-, I70.43-, I70.44-, I70.53-, I70.54-, I70.63-, I70.64-, I70.73-, I70.74-) chronic venous hypertension (I87.31-, I87.33-) diabetic ulcers (E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621,E13.622) postphlebitic syndrome (I87.01-, I87.03-) postthrombotic syndrome (I87.01-, I87.03-) varicose ulcer (I83.0-, I83.2-) The code first list is used to indicate order for code assignment. The causation for the ulcer should be documented in the medical record. According to the instructional notes, that causation would be listed first, followed by the ulcer code(s). Physicians and other providers will need to document more specific information in order to assign an appropriate code. Otherwise, unspecified codes will be assigned. These codes have the potential to cause adjudication problems, including denials and pended claims. The information that needs to be documented for non-pressure ulcers is anatomic location, laterality (when applicable), severity, and causation (as demonstrated above). Below is a listing of the codes for non-pressure chronic ulcer broken down by severity, then site. This can be used as a quick reference, or as a tool to share with providers. NON-PRESSURE CHRONIC ULCERS LIMITED TO BREAKDOWN OF SKIN L97.111Non-pressure chronic ulcer of right thigh limited to breakdown of skin L Non-pressure chronic ulcer of left thigh limited to breakdown of skin L Non-pressure chronic ulcer of right calf limited to breakdown of skin L Non-pressure chronic ulcer of left calf limited to breakdown of skin L Non-pressure chronic ulcer of right ankle limited to breakdown of skin L Non-pressure chronic ulcer of left ankle limited to breakdown of skin L Non-pressure chronic ulcer of right heel and midfoot limited to breakdown of skin L Non-pressure chronic ulcer of left heel and midfoot limited to breakdown of skin L Non-pressure chronic ulcer of other part of right foot limited to breakdown of skin L Non-pressure chronic ulcer of other part of left foot limited to breakdown of skin L Non-pressure chronic ulcer of other part of right lower leg limited to breakdown of skin AAPC. All rights reserved.
2 L Non-pressure chronic ulcer of other part of left lower leg limited to breakdown of skin L Non-pressure chronic ulcer of buttock limited to breakdown of skin L Non-pressure chronic ulcer of back limited to breakdown of skin L Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin NON-PRESSURE CHRONIC ULCERS WITH FAT LAYER EXPOSED L Non-pressure chronic ulcer of right thigh with fat layer exposed L Non-pressure chronic ulcer of left thigh with fat layer exposed L Non-pressure chronic ulcer of right calf with fat layer exposed L Non-pressure chronic ulcer of left calf with fat layer exposed L Non-pressure chronic ulcer of right ankle with fat layer exposed L Non-pressure chronic ulcer of left ankle with fat layer exposed L Non-pressure chronic ulcer of right heel and midfoot with fat layer exposed L Non-pressure chronic ulcer of left heel and midfoot with fat layer exposed L Non-pressure chronic ulcer of other part of right foot with fat layer exposed L Non-pressure chronic ulcer of other part of left foot with fat layer exposed L Non-pressure chronic ulcer of other part of right lower leg with fat layer exposed L Non-pressure chronic ulcer of other part of left lower leg with fat layer exposed L Non-pressure chronic ulcer of buttock with fat layer exposed L Non-pressure chronic ulcer of back with fat layer exposed L Non-pressure chronic ulcer of skin of other sites with fat layer exposed NON-PRESSURE CHRONIC ULCERS WITH NECROSIS OF MUSCLE L Non-pressure chronic ulcer of right thigh with necrosis of muscle L Non-pressure chronic ulcer of left thigh with necrosis of muscle L Non-pressure chronic ulcer of right calf with necrosis of muscle L Non-pressure chronic ulcer of left calf with necrosis of muscle L Non-pressure chronic ulcer of right ankle with necrosis of muscle L Non-pressure chronic ulcer of left ankle with necrosis of muscle L Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle L Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle L Non-pressure chronic ulcer of other part of right foot with necrosis of muscle L Non-pressure chronic ulcer of other part of left foot with necrosis of muscle L Non-pressure chronic ulcer of other part of right lower leg with necrosis of muscle L Non-pressure chronic ulcer of other part of left lower leg with necrosis of muscle AAPC. All rights reserved.
3 L Non-pressure chronic ulcer of buttock with necrosis of muscle L Non-pressure chronic ulcer of back with necrosis of muscle L Non-pressure chronic ulcer of skin of other sites with necrosis of muscle NON-PRESSURE CHRONIC ULCERS WITH NECROSIS OF BONE L Non-pressure chronic ulcer of right thigh with necrosis of bone L Non-pressure chronic ulcer of left thigh with necrosis of bone L Non-pressure chronic ulcer of right calf with necrosis of bone L Non-pressure chronic ulcer of left calf with necrosis of bone L Non-pressure chronic ulcer of right ankle with necrosis of bone L Non-pressure chronic ulcer of left ankle with necrosis of bone L Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone L Non-pressure chronic ulcer of left heel and midfoot with necrosis of bone L Non-pressure chronic ulcer of other part of right foot with necrosis of bone L Non-pressure chronic ulcer of other part of left foot with necrosis of bone L Non-pressure chronic ulcer of other part of right lower leg with necrosis of bone L Non-pressure chronic ulcer of other part of left lower leg with necrosis of bone L Non-pressure chronic ulcer of buttock with necrosis of bone L Non-pressure chronic ulcer of back with necrosis of bone L Non-pressure chronic ulcer of skin of other sites with necrosis of bone Following is the listing of the unspecified codes for non-pressure chronic ulcers. These should rarely be used as they may cause delay or denial of claims. NON-PRESSURE CHRONIC ULCERS WITH UNSPECIFIED SEVERITY L Non-pressure chronic ulcer of right thigh with unspecified severity L Non-pressure chronic ulcer of left thigh with unspecified severity L Non-pressure chronic ulcer of right calf with unspecified severity L Non-pressure chronic ulcer of left calf with unspecified severity L Non-pressure chronic ulcer of right ankle with unspecified severity L Non-pressure chronic ulcer of left ankle with unspecified severity L Non-pressure chronic ulcer of right heel and midfoot with unspecified severity L Non-pressure chronic ulcer of left heel and midfoot with unspecified severity L Non-pressure chronic ulcer of other part of right foot with unspecified severity L Non-pressure chronic ulcer of other part of left foot with unspecified severity L Non-pressure chronic ulcer of other part of right lower leg with unspecified severity AAPC. All rights reserved.
4 L Non-pressure chronic ulcer of other part of left lower leg with unspecified severity L Non-pressure chronic ulcer of buttock with unspecified severity L Non-pressure chronic ulcer of back with unspecified severity L Non-pressure chronic ulcer of skin of other sites with unspecified severity NON-PRESSURE CHRONIC ULCERS WITH UNSPECIFIED SITES L97.10 Non-pressure chronic ulcer of unspecified thigh L Non-pressure chronic ulcer of unspecified thigh limited to breakdown of skin L Non-pressure chronic ulcer of unspecified thigh with fat layer exposed L Non-pressure chronic ulcer of unspecified thigh with necrosis of muscle L Non-pressure chronic ulcer of unspecified thigh with necrosis of bone L Non-pressure chronic ulcer of unspecified thigh with unspecified severity L97.20 Non-pressure chronic ulcer of unspecified calf L Non-pressure chronic ulcer of unspecified calf limited to breakdown of skin L Non-pressure chronic ulcer of unspecified calf with fat layer exposed L Non-pressure chronic ulcer of unspecified calf with necrosis of muscle L Non-pressure chronic ulcer of unspecified calf with necrosis of bone L Non-pressure chronic ulcer of unspecified calf with unspecified severity L97.30 Non-pressure chronic ulcer of unspecified ankle L Non-pressure chronic ulcer of unspecified ankle limited to breakdown of skin L Non-pressure chronic ulcer of unspecified ankle with fat layer exposed L Non-pressure chronic ulcer of unspecified ankle with necrosis of muscle L Non-pressure chronic ulcer of unspecified ankle with necrosis of bone L Non-pressure chronic ulcer of unspecified ankle with unspecified severity L97.40 Non-pressure chronic ulcer of unspecified heel and midfoot L97.401Non-pressure chronic ulcer of unspecified heel and midfoot limited to breakdown of skin L Non-pressure chronic ulcer of unspecified heel and midfoot with fat layer exposed L Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of muscle L Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of bone L Non-pressure chronic ulcer of unspecified heel and midfoot with unspecified severity AAPC. All rights reserved.
5 L97.50 Non-pressure chronic ulcer of other part of unspecified foot L Non-pressure chronic ulcer of other part of unspecified foot limited to breakdown of skin L Non-pressure chronic ulcer of other part of unspecified foot with fat layer exposed L Non-pressure chronic ulcer of other part of unspecified foot with necrosis of muscle L Non-pressure chronic ulcer of other part of unspecified foot with necrosis of bone L Non-pressure chronic ulcer of other part of unspecified foot with unspecified severity L97.80 Non-pressure chronic ulcer of other part of unspecified lower leg L97.801Non-pressure chronic ulcer of other part of unspecified lower leg limited to breakdown of skin L Non-pressure chronic ulcer of other part of unspecified lower leg with fat layer exposed L Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of muscle L Non-pressure chronic ulcer of other part of unspecified lower leg with necrosis of bone L Non-pressure chronic ulcer of other part of unspecified lower leg with unspecified severity L97.90 Non-pressure chronic ulcer of unspecified part of unspecified lower leg L Non-pressure chronic ulcer of unspecified part of unspecified lower leg limited to breakdown of skin L Non-pressure chronic ulcer of unspecified part of unspecified lower leg with fat layer exposed L Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of muscle L Non-pressure chronic ulcer of unspecified part of unspecified lower leg with necrosis of bone L Non-pressure chronic ulcer of unspecified part of unspecified lower leg with unspecified severity L97.91 Non-pressure chronic ulcer of unspecified part of right lower leg L Non-pressure chronic ulcer of unspecified part of right lower leg limited to breakdown of skin L Non-pressure chronic ulcer of unspecified part of right lower leg with fat layer exposed L Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of muscle L Non-pressure chronic ulcer of unspecified part of right lower leg with necrosis of bone L Non-pressure chronic ulcer of unspecified part of right lower leg with unspecified severity L97.92 Non-pressure chronic ulcer of unspecified part of left lower leg L Non-pressure chronic ulcer of unspecified part of left lower leg limited to breakdown of skin L Non-pressure chronic ulcer of unspecified part of left lower leg with fat layer exposed L Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of muscle L Non-pressure chronic ulcer of unspecified part of left lower leg with necrosis of bone L Non-pressure chronic ulcer of unspecified part of left lower leg with unspecified severity AAPC. All rights reserved.
E08.621 Diabetes mellitus due to underlying condition with foot ulcer E09.621 Drug or chemical induced diabetes mellitus with foot ulcer E10.10 Type 1 diabetes mellitus with ketoacidosis without coma E10.11
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