Podiatry Coding & Billing Alert

Question: A patient with uncontrolled type 2 diabetes mellitus (DM) presents with Charcot foot that requires treatment. What ICD-9 code should I use to report this condition?

Kentucky Subscriber

Answer: You should work from the bottom up when coding for Charcot foot. First, be prepared to use a secondary diagnosis code, which would be 713.5 (Arthropathy associated with neurological disorders). Both Charcot's arthropathy associated with diseases classifiable elsewhere and neuropathic arthritis associated with diseases classifiable elsewhere fall under code 713.5, according to the brackets following the code's description.

Then, move up to the underlying disease to describe the primary diagnosis. In this case, you should note three possibilities:

• tabetic [syphilitic] (094.0)
• diabetic (249.6, 250.6)
• syringomyelic (336.0)

Warning: Don't be too quick to bill 250.00 (Diabetes mellitus) as your primary diagnosis. While it is the most common cause of Charcot arthropathy, there are others. If the podiatrist diagnosed Charcot foot due to diabetes, you would report 250.6x (Diabetes with neurological manifestations) before 713.5.

Background: Charcot foot is also called Charcot's joint or neuropathic arthropathy. It occurs when a joint deteriorates because of nerve damage, a common complication of diabetes.