# diabetic patient with decubitus ulcers



## sundaey (Sep 22, 2009)

Hello everyone,
I was looking through the ICD-9 guidelines for an answer to this question and couldn't find it. A patient is seen in consultation for a stage 4 decubitus ulcer. The doctor documents that the patient has diabetes, but does not necessarily say that the ulcers are a complication from the diabetes. Do I still use the 250.80 code for the diabetic manifestation, or do I just code the site and stage of the ulcer???

thanks to you all.....


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## clmoreland (Sep 23, 2009)

*Diabetic codes*



sundaey said:


> Hello everyone,
> I was looking through the ICD-9 guidelines for an answer to this question and couldn't find it. A patient is seen in consultation for a stage 4 decubitus ulcer. The doctor documents that the patient has diabetes, but does not necessarily say that the ulcers are a complication from the diabetes. Do I still use the 250.80 code for the diabetic manifestation, or do I just code the site and stage of the ulcer???
> 
> thanks to you all.....



What I have seen most for diabetic complications are the decubitus ulcers on the feet.  Is the patient bedridden?  I would just code decubitis ulcer 707.03 and code the diabetes.  I do code for the heel decubitis as 707.14 and the 205.60 if the patient has peripheral neuropathy.  Hope this helps.


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## FTessaBartels (Sep 23, 2009)

*Doctor MUST make the connection*

In order to use the 250.xx series of codes the provider MUST make the connection for you. 

If he didn't, then code the ulcer and the diabetes as separate diagnoses.

F Tessa Bartels, CPC, CEMC


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## dpeoples (Sep 23, 2009)

sundaey said:


> Hello everyone,
> I was looking through the ICD-9 guidelines for an answer to this question and couldn't find it. A patient is seen in consultation for a stage 4 decubitus ulcer. The doctor documents that the patient has diabetes, but does not necessarily say that the ulcers are a complication from the diabetes. Do I still use the 250.80 code for the diabetic manifestation, or do I just code the site and stage of the ulcer???
> 
> thanks to you all.....



The doctor does not make the connection, and the guidelines do not require the causal condition (as is the case with 707.1_), so you do not need to code the diabetes, but you certainly could, and perhaps should since it is documented.

And you definitely should use the additional code for the stage of the ulcer, so....
707.00, 707.24,250.00 is how I would code this scenario.


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## mitchellde (Sep 23, 2009)

I would not code the diabetes AS 250.80 since this is not documented as a complication of the diabetes.  The diabetes code then would be 250.00, listing the ulcer and the stage first.


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## kumeena (Sep 24, 2009)

I agree with Debra. Only the kidney problems for Diabetic patients we can link together. Otherwise no documentation from the Doctor (Ex: diabetic neuropathy/ due to diabetes )we can not code it


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