Home Health ICD-9/ICD-10 Alert

Question: How would you code Fournier's gangrene in a female patient? The Index to Diseases points to 608.83, but the Tabular says this is limited to male genitalia.

-- Nevada Subscriber

Answer: Women can indeed have Fournier's gangrene, a bacterial infection of the skin of the genitals and perineum. Unfortunately 608.83 doesn't accommodate this situation.

Try looking under "inflammation, genital organ, female" instead, says Charlotte Lefert, RHIA, coding strategy facilitator for the LTC Community of Practice for the American Health Information Management Association.

This directs you to 614.9 (Unspecified inflammatory disease of female pelvic organs and tissues). Reading that code description in the tabular list of your ICD-9 manual, you'll notice that it's not quite right in your patient's case because she has a specified condition -- Fournier's gangrene.

Look up the list of codes and you'll see 614.8 (Other specified inflammatory disease of female pelvic organs and tissues) -- that's the code to use.

Coming soon: ICD-10 does include an entry in the alphabetic index that directs you to a specific code for female Fournier's gangrene -- N76.8 (Other specified inflammation of vagina and vulva).