Wiki Atherosclerosis/PVD and foot ulcer

[Elizabethchris]

Hi all! I was wondering if you I can assume causal relationship between Atherosclerosis/PVD and Ulcer if provider indicated, "chronic skin ulcer of bilat LE, atherosclerosis/PVD, presenting today for c/o worsening LE edema and skin ulcer." Since provider indicated Atherosclerosis/PVD, I'll report code I70.2***, but can I assume the ulcer is due to Athero/PVD? Thanks.

 

[Munzueta]

Actually, you can!

So patient has Atherosclerosis/PVD. Usually PVD code to I73.9, but in your case, the provider is being more specific as to being atherosclerosis type. If you go to your index under Disease>Vascular>Arteriosclerosis it says "see Arteriosclerosis."

So go to Arteriosclerosis>extremeties>leg>left and right>with>ulceration. Now based on your information provided, patient has ulcers on both legs, so this will give you 2 codes, I70.248 and I70.238, these codes represent the PVD/atherosclerosis portion, if you go check them out it will have an instructional note to use additional codes to identify the type of "pressure ulcers" in this case, which based on the information provided, should be L97.829 and L97819.

So now, how are you able to assume? because your index, on both codes has the "with" term included as well as the description of the codes. Guideline I.A.15 "With" allows you to assume a causal relationship on any conditions linked by the term "with."

Thats how you would be able to justify it.

Hope it helps!