Home Health ICD-9/ICD-10 Alert

Reader Questions:

707.xx: Mind Your Sequencing with Ulcers

Question:

We are providing wound care for a new patient. He has bilateral pressure ulcers of the buttocks. One is a stage 3 and the other a stage 2. He also has a stage 4 pressure ulcer of the sacrum. How should we code for this patient?

--Vermont Subscriber

Answer:

Code for this patient as follows:

M1020a: 707.03 (Pressure ulcer; sacrum);

M1022b: 707.24 (Pressure ulcer stage IV);

M1022c: 707.05 (Pressure ulcer; buttock);

M1022d: 707.23 (Pressure ulcer stage III); and

M1022e: 707.22 (Pressure ulcer stage II).

His stage 4 ulcer is the most complex and will require the most care, so sequence it first. Follow it with 707.24 to indicate the ulcer's stage.

Remember: Stage 3 and 4 ulcers may close, but are never considered fully healed, so you will continue to report this patient's ulcers on the OASIS in any future episodes.

Next, list 707.05 to indicate your patient's pressure ulcers of the buttocks. You need only list this code once, but you will list two staging codes to indicate that the patient has two pressure ulcers of differing stages on his buttocks.

Tip: If the patient had two or more pressure ulcers of the same stage in the same location, you would only list a single pair of location and stage codes. ICD-9 doesn't provide the ability to code in greater specificity in this situation.