262.
Gangrene is dead tissue (necrosis) consequent to ischemia. In the image above, we can see a black area on half of the big toe in a diabetic patient. This black area represents necrosis—dead tissue—in fact, gangrene of the big toe.
I96 - Gangrene, not elsewhere classified | ICD-10-CM.
262 - Atherosclerosis of native arteries of extremities with gangrene, left leg.
Gangrene is a serious condition where a loss of blood supply causes body tissue to die. It can affect any part of the body but typically starts in the toes, feet, fingers and hands. Gangrene can occur as a result of an injury, infection or a long-term condition that affects blood circulation.
Wet gangrene typically occurs in people who have frostbite or experience a severe burn. People with diabetes may unknowingly develop wet gangrene after experiencing a minor toe or foot injury. Blood flow to the extremities is generally diminished in people with diabetes.
Atherosclerosis of native arteries of extremities with gangrene, right leg. I70. 261 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM I70.
A: The coder would report ICD-10-CM code I96 (gangrene, not elsewhere classified) as the principal diagnosis because of the “code first” note under code category L89. - (pressure ulcer).
621, Foot ulcer, and directly beneath that, code E11. 52, Gangrene.
Document to the highest specificity and severity. E11. 51 Diabetes type II with PAD/PVD (no need to add code I73. 9) • Code I73.
Necrosis is commonly documented in the patient records with traumatic wounds, burns, pressure sores etc. Necrosis due to lack of oxygen such as with a MI would be considered part of the MI code as would any necrosis with infection in pneumonia. Gangrene would seem to be a complication of necrotic tissue.
ICD 10 codes from Z89. 43 series are used for reporting amputation of foot or absence of foot. In this procedure, the physician amputates the foot across the transmetatarsal region.
The 2022 edition of ICD-10-CM T87.89 became effective on October 1, 2021.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code.
The 2022 edition of ICD-10-CM S98.912A became effective on October 1, 2021.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.
However, I strongly object to the characterization that the “gangrene is associated with the pressure ulcer rather than the diabetes mellitus.”. Gangrene has to affect a body part (e.g., musculoskeletal system, intestine portion, gallbladder, etc.); it does not occur diffusely, i.e., directly due to diabetes.
In the first article in this series, I compared pressure ulcers and diabetic foot ulcers (the latter are considered non-pressure chronic ulcers in ICD-10-CM). My conclusion was that there is significant overlap, but heel ulcers are prime candidates to be classified as pressure injuries by providers. Ultimately, their documentation will determine whether an ulcer on the foot of a diabetic will be considered a “diabetic foot ulcer” or a pressure ulcer. This article will explore whether they are mutually exclusive conditions.