Non-pressure chronic ulcer of lower limb, not elsewhere classified L97- 1 chronic ulcer of skin of lower limb NOS 2 non-healing ulcer of skin 3 non-infected sinus of skin 4 trophic ulcer NOS 5 tropical ulcer NOS 6 ulcer of skin of lower limb NOS
The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code ( L97) and the excluded code together.
Non-pressure chronic ulcers are similar to pressure ulcers in that they require documentation of the site, severity and laterality. Category L97 and L98 are for non-pressure ulcers, and have an instructional note to code first any associated underlying condition, such as: The severity of the ulcers is described as:
Non-pressure chronic ulcers are similar to pressure ulcers in that they require documentation of the site, severity and laterality. Category L97 and L98 are for non-pressure ulcers, and have an instructional note to code first any associated underlying condition, such as: 1 Associated gangrene 2 Atherosclerosis of the lower extremities 3 Chronic venous hypertension 4 Diabetic ulcers 5 Postphlebetic syndrome 6 Postthrombotic syndrome 7 Varicose ulcers
The pressure ulcers on the elbows are documented as partial thickness into the dermis, which supports stage 2 (stated to be healing or abrasion, blister, partial thickness skin loss involving epidermis and/or dermis)—which again matches the physician documentation.
CPR’s “Coding Corner” focuses on coding, compliance and documentation issues relating specifically to physician billing. This month’s tip comes from Peggy Silley, the Director of ICD-10 Development and Training for AAPC, a training and credentialing association for the business side of health care.
ICD-10 Code Assignment for Pressure/Non Pressure Ulcers 1 Stage 1: Skin changes limited to persistent focal edema 2 Stage 2: An abrasion, blister, and partial thickness skin loss involving the dermis and epidermis 3 Stage 3: Full thickness skin loss involving damage and necrosis of subcutaneous tissue 4 Stage 4: Necrosis of soft tissues through the underlying muscle, tendon, or bone 5 Unstageable: Based on clinical documentation the stage cannot be determined clinically (e.g., the wound is covered with eschar) or for ulcers documented as deep tissue injury without evidence of trauma.
The pressure ulcers on the elbows are documented as partial thickness into the dermis, which supports stage 2 (stated to be healing or abrasion, blister, partial thickness skin loss involving epidermis and/or dermis)—which again matches the physician documentation.
Category L97 and L98 are for Non-pressure ulcers, and have an instructional note to code first any associated underlying condition, such as: Associated gangrene. Atherosclerosis of the lower extremities. Chronic venous hypertension.
The term “non-pressure ulcer” was coined to designate a primary mechanism other than shear or pressure. If there is poor circulation, such as that caused by venous or arterial insufficiency or excessive moisture or trauma, a patient may develop a non-pressure ulcer.
An additional L89 code specifies the stage (depth of tissue injury) and the anatomical site. Pressure ulcers form in sites that experience shear or pressure, typically in tissue overlying bony prominences such as elbows, the sacrum, hips, or heels. After sacral, heel ulcers are the second most common type of pressure injury.
Pressure ulcers form in sites that experience shear or pressure, typically in tissue overlying bony prominences such as elbows, the sacrum, hips, or heels. After sacral, heel ulcers are the second most common type of pressure injury. The etymology of the term “decubitus ulcer” is from the Latin, decumbere, which means “to lie down,” ...
A “diabetic foot ulcer,” which is caused exclusively by hyperglycemia, in the absence of neuropathy or ischemia, is a rarity. That term almost always refers to an ulcer on the foot of a diabetic that derives from neuro/ischemic etiology, as opposed to being strictly and principally due to pressure injury.
Heel ulcers, however, are usually a consequence of a pressure injury, although it is also possible to have another mechanism cause a non-pressure injury involving the heel. Diabetes may accelerate or complicate the injury. Neuropathy results in malum perforans pedis (a.k.a. bad perforating foot) ulcers.
The American Podiatric Medical Association adds that “ (diabetic foot) ulcers form due to a combination of factors , such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes .”. They go on to note that “vascular disease can complicate a foot ulcer, ...
The plantar surface is the most common site of ulceration, especially at areas of bony prominence.”.
Without further instruction in the code set, coders assign the default code for pressure ulcers. Once the ulcer is classified as a Kennedy terminal ulcer, however, coders can no longer code it as a pressure ulcer. Present on admission (POA) indicators are also vital for pressure ulcer reporting.
A: A Kennedy terminal ulcer is a type of skin ulcer and not clinically considered the same as a pressure ulcer. They’re thought to be caused by poor tissue perfusion during the dying process, but we need more information in general.