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Primary Care Coding Alert

Reader Question:

What's Missing Determines 707.00 Versus 707.09

Published on Wed Oct 27, 2004

Question: I noticed that ICD-9 2005 added an "unspecified site" and "another specified" decubitus ulcer code. When should I use each diagnosis?

Tennessee Subscriber Answer: You should choose between 707.00 (Decubitus ulcer; unspecified site) and 707.09 (... other site) based on your family physician's documentation.

Think of the different diagnoses as lack of information versus lack of CPT code. If the FP doesn't dictate the ulcer's site, and you have no other information about the sore, you should report the unspecified site with 707.00.

On the other hand, when CPT doesn't contain a code that describes the decubitus ulcer site that the physician treated, you should use 707.09 for another specified site.

Example: An FP treats a bedsore on a nursing-home patient's calf. Because no CPT code describes a decubitus ulcer code on the calf, you should submit other site with 707.09.
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