October’s diagnosis update isn’t just a file refresh; it’s an invitation to level up clinical specificity—the difference between smooth payments and needless denials. 

Non‑pressure ulcers (L97‑): how to pick the right code every time 

•  Anatomic site is king: Choose among heel/midfoot/other part of foot/ankle and add laterality. Your note should state the exact site (e.g., “plantar heel”) and map to the right subcategory. 

•  Depth/severity matters: Select the character matching breakdown of skin, with fat layer 

exposed, with necrosis of muscle, or with necrosis of bone. Insert the post‑debridement measurements so the level you billed is obvious to auditors. 

•  Underlying cause: When the ulcer is diabetic, pair with E11.621 (Type 2 DM with foot ulcer) and, if present, E11.40‑E11.52 family codes for neuropathy/angiopathy. Add infection (cellulitis/ osteomyelitis) and ischemia codes as indicated. 

Injury coding tune‑up 

•  7th character discipline: Initial (A) for active treatment (e.g., casting, surgical care, ED‑level management); subsequent (D) when routine healing is underway; sequela (S) for late effects (e.g., chronic pain or deformity after a healed fracture). 

•  External cause codes: Not usually required for payment, but they support analytics and can resolve 

payer edits—use them when your state/program requires. 

•  Common foot injuries: Precisely code metatarsal fractures, Lisfranc sprains, Achilles ruptures, and toe dislocations with laterality and encounter type—important for risk scoring and authorization. 

Templates that save the day 

Create EHR templates that force entry of site, laterality, depth, tissue removed, offloading method, vascular status, and diabetes linkage. Require a healing trajectory note: “% reduction” or “stalled— escalated to vascular consult.” 

A Step Above Health Mgmt advantage We install smart templates, train clinicians on what auditors look for, and run monthly denial post‑mortems so your charts evolve with payer behavior—not after the fact.