Home Health ICD-9/ICD-10 Alert

Question: When coding stasis ulcers, when should I report 454.0? When should I code 459.81 with 707.1x?

Answer: Code from the 454.x category (Varicose veins of lower extremities) only if the stasis ulcer is associated with a varicose vein. In that case, a code from the 707.1x subcategory (Chronic ulcer of skin, ulcer of lower limbs, except decubitus) is not required.
 
If the ulcer is not associated with a varicose vein, does the patient have postphlebitic syndrome (459.1x) or chronic venous hypertension (453.3x)? 

If either of these is documented, then code the appropriate fifth digit and add a code from the 707.1x subcategory to indicate the location of the ulcer. 

The majority of the time, you will code 459.81 (Other specified disorders of the circulatory system, venous [peripheral]) insufficiency, unspecified) for venous insufficiency and use an additional code for the ulceration from the 707.1x series.