Diabetic Foot Ulcer - Classification

Classification

Identification of diabetic foot in medical databases, such as commercial claims and prescription data, is complicated by the lack of a specific ICD-9 code for diabetic foot and variation in coding practices. The following codes indicate ulcer of the lower limb or foot:

• 707.1 Ulcer of lower limbs, except pressure ulcer
• 707.14 Ulcer of heel and midfoot
• 707.15 Ulcer of other part of foot
• 707.19 Ulcer of other part of lower limb

One or more codes, in combination with a current or prior diagnosis of diabetes may be sufficient to conclude diabetic foot:

• 250.0 Diabetes Mellitus
• 250.8 Diabetes with other specified manifestations

Sohn et al. survey alternative methods used in published literature. In particular, they note:

"Ramsey et al. used the simplest method, involving only one diagnostic code (ICD-9-CM 707.1×, "Ulcer of lower limbs, except decubitus"), in a study of incidence rates and treatment costs of foot ulcers among individuals enrolled in a HMO. In a validation study, this method was shown to have 74% sensitivity and 94% specificity compared to medical records."