Question 1/2/3/4

Rationale: Refer to ICD-10-CM guideline I.C.12.a for pressure ulcer stage codes. ICD-10-CM guideline I.C.12.a.2 indicates that when there is no documentation regarding the stage of the pressure ulcer, assign the appropriate unspecified stage code.

Reporting an unstageable pressure ulcer is based on the clinical documentation.

ICD-10-CM guideline I.C.12.a.6 indicates if a patient is admitted with a pressure ulcer at one stage and it progresses to a higher stage, assign two codes: 1) assign the code for the site and stage of the ulcer on admission, and 2) assign the code for the highest stage reported for that site.

Section I.C.12.a.1 indicates that one code, a combination code, is reported for both the site of the ulcer and stage of the ulcer.

Question 5

Rationale:

Rationale: Refer to ICD-10-CM guideline I.C.12.a.2. If the pressure ulcer is documented as unstageable, assign L89.--0.

Unstageable is when the base of the ulcer is covered in eschar or slough so much that it cannot be determined how deep the ulcer is. This diagnosis is determined based on the clinical documentation. This code should not be used if the stage is not documented. In that instance, report the unspecified code, L89.--9.

ICD-10-CM Alphabetic Index: Ulcer, ulcerated, ulcerating, ulceration, ulcerative > Pressure (pressure area) > Unstageable > Hip > L89.2-.

In the Tabular List the 5^th character 1 indicates the right hip and 6^th character 0 indicates unstageable.

Question 6

Rationale:

ICD-10-CM Alphabetic Index: Diabetes, diabetic (mellitus) (sugar) > with > skin ulcer NEC > E11.622. 

In the Tabular List, below E11.622, there is a note to use an additional code to identify the site of the ulcer (L97.1-L97.9, L98.41-L98.49). 

A review of this code range identifies L97.319 Non-pressure chronic ulcer of right ankle with unspecified severity.

ICD-10-CM Alphabetic Index: Ulcer > lower limb > ankle > right > L97.319.

In the Tabular List, under category code L97, there is a note to code first any associated underlying condition, including diabetic ulcers and their corresponding codes.

Verify code selection in the Tabular List. 

Question 7

Rationale:

ICD-10-CM Alphabetic Index: Encephalopathy (acute) > G93.40. Verify code selection in the Tabular List.

The pressure ulcer is stated as healed and would not be coded according to ICD-10-CM guideline I.C.12.a.4, which states, “No code is assigned if the documentation states that the pressure ulcer is completely healed.”

Question 8

Rationale:

ICD-10-CM Alphabetic Index: Lesion > skin > L98.9

Verify code selection in the Tabular List.

Question 9

Rationale:

ICD-10-CM Alphabetic Index: Alopecia > Totalis > L63.0

Verify code selection in the Tabular List. 

Question 10

Rationale:

ICD-10-CM Alphabetic Index: Impetigo > Bockhart’s > L01.02