Home Health ICD-9/ICD-10 Alert

Question: There has been disagreement in the homecare coding community regarding ischial tuberosity pressure ulcers. The controversy stems from the anatomic location: is this to be coded to the buttock (707.05) or the ischeal bone (707.04)? What guidance does Coding Clinic have on this subject?

New Hampshire Subscriber

Answer: The Coding Clinic doesn't have any guidance on this matter. Your knowledge of anatomy and physiology rules in this case. The ischial tuberosity is also known as the "sitting bone," that bone that hurts when you sit on a hard chair too long. Therefore the 707.05 code for the buttock is the correct choice. Pressure ulcers on the hip involve the greater trochanter of the femur.

Caution: Coding a pressure ulcer on the ischial tuberosity with the code for hip will result in the patient not qualifying for a pressure relieving device in his wheelchair, something that is necessary for a pressure ulcer on the buttock.