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Z89.512
ICD-10-CM
Left Below-Knee Amputation (BKA)

Find comprehensive information on Left Below-Knee Amputation BKA including clinical documentation, medical coding, ICD-10 codes, healthcare guidelines, and postoperative care. This resource covers amputation levels, prosthetic considerations, rehabilitation, and pain management for left BKA. Learn about diagnostic criteria, treatment options, and resources for patients with left below knee amputations.

Also known as

Left BKA
Left Leg Amputation Below Knee

Diagnosis Snapshot

Key Facts
  • Definition : Surgical removal of the left leg below the knee joint.
  • Clinical Signs : Absent left leg below knee, surgical scar, potential phantom limb pain.
  • Common Settings : Trauma, peripheral artery disease, infection, diabetes complications.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC Z89.512 Coding
Z89.4-

Acquired absence of limb

Codes for acquired absence of limbs, including below-knee amputation.

S88.-

Injury of lower leg

Includes injuries to the lower leg that may lead to amputation.

E10-E14

Diabetes mellitus

Diabetes is a common cause of lower limb amputations.

I70-I79

Peripheral vascular disease

Peripheral vascular disease can lead to amputations like BKA.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the amputation traumatic?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Left Below-Knee Amputation
Left Above-Knee Amputation
Left Foot Amputation

Documentation Best Practices

Documentation Checklist
  • Left BKA: Amputation level, cause, surgical technique
  • Left BKA: Residual limb length, condition, complications
  • Left BKA: Prosthetic fitting, rehab plan, functional goals
  • Left BKA: ICD-10 Z89.414, CPT codes for amputation, revision

Mitigation Tips

Best Practices
  • Document BKA etiology, laterality, and level for accurate ICD-10 coding (Z89.41-).
  • Ensure complete pre- and post-op notes capture amputation reason, surgical technique.
  • Query physician for unclear BKA documentation. Improve CDI for specific codes.
  • Monitor compliance with payer guidelines for prosthetic coverage, rehab services.
  • Regularly audit BKA documentation to minimize denials and optimize reimbursement.

Clinical Decision Support

Checklist
  • Confirm documented trauma/disease necessitates L BKA (ICD-10 Z89.41)
  • Verify imaging confirms non-salvageable limb below knee
  • Ensure vascular assessment completed pre-op
  • Check patient consent for L BKA procedure documented

Reimbursement and Quality Metrics

Impact Summary
  • Left Below-Knee Amputation (BKA) Reimbursement: ICD-10 Z89.414, CPT 27886 impacts MS-DRG assignment, affecting hospital payments.
  • Coding accuracy for BKA is crucial. Proper ICD-10 and CPT coding (including laterality) maximizes reimbursement, avoids denials.
  • BKA quality metrics: Length of Stay (LOS), Post-op complications, and readmission rates impact hospital quality reporting and value-based purchasing.
  • Optimize BKA documentation to support coding accuracy and justify medical necessity, improving reimbursement and patient care.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective post-operative pain management strategies for patients with a left below-knee amputation (BKA)?

A: Effective post-operative pain management for left BKAs requires a multimodal approach addressing both phantom limb pain (PLP) and residual limb pain. This includes pharmacological interventions such as opioid analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentinoids (pregabalin, gabapentin), and NMDA receptor antagonists (ketamine). Non-pharmacological strategies like mirror therapy, transcutaneous electrical nerve stimulation (TENS), and psychological counseling can also significantly reduce pain and improve patient outcomes. Consider implementing a comprehensive pain management plan involving a multidisciplinary team (anesthesiologist, surgeon, physical therapist, psychologist) to address the complex nature of post-amputation pain. Explore how early intervention with preemptive analgesia can minimize the development of chronic pain. Learn more about the role of regional anesthesia techniques in reducing post-operative opioid requirements.

Q: How can I differentiate between phantom limb pain and residual limb pain in a patient after a left below-knee amputation, and what are the specific treatment approaches for each?

A: Differentiating between phantom limb pain (PLP) and residual limb pain after a left BKA is crucial for effective treatment. PLP is felt in the missing portion of the limb and may be described as burning, cramping, shooting, or electric sensations. Residual limb pain is localized to the remaining limb and can result from neuroma formation, infection, wound healing issues, or poorly fitting prostheses. Treatment for PLP often includes medications like gabapentinoids, antidepressants, and mirror therapy. Residual limb pain management focuses on addressing the underlying cause, which may involve antibiotics for infections, revision surgery for neuromas, wound care optimization, or prosthetic adjustments. Explore the latest research on targeted nerve blocks and other interventional pain management techniques for both PLP and residual limb pain. Consider implementing a detailed patient history and physical examination to accurately diagnose the source of pain and guide treatment decisions.

Quick Tips

Practical Coding Tips
  • Code Z89.414 BKA
  • Validate laterality in docs
  • Check ICD-10 guidelines
  • Query physician for details
  • Consider partial amputation codes

Documentation Templates

Patient presents with a left below-knee amputation (BKA), status post surgical amputation performed on [Date of amputation].  The amputation level is [Specify level, e.g., transtibial, long transtibial, short transtibial].  Indication for amputation was [Specific reason for amputation, e.g., peripheral artery disease, critical limb ischemia, traumatic injury, infection].  Patient reports [Pain description, e.g., phantom limb pain, residual limb pain, incisional pain].  Pain is characterized as [Pain characteristics, e.g., burning, throbbing, stabbing, constant, intermittent] and rated [Pain scale rating] on a numerical rating scale (0-10).  Wound healing at the amputation site is [Description of wound healing, e.g., progressing well, delayed, complicated by infection].  Residual limb edema is [Present/Absent].  Patient is currently [Ambulatory status, e.g., non-weight bearing, partial weight bearing, full weight bearing] and using [Assistive device, e.g., wheelchair, walker, crutches].  Prosthetic fitting is [Planned, in progress, completed].  Patient demonstrates understanding of postoperative care instructions, including wound care, pain management, and exercises to improve range of motion and strength.  Plan includes continued monitoring of wound healing, pain management, physical therapy for gait training and strengthening, and occupational therapy for activities of daily living.  Referral to prosthetist has been made.  Diagnosis codes include [ICD-10 code for acquired absence of left leg below knee, Z89.414, and other applicable ICD-10 codes for underlying conditions].  CPT codes for today's visit include [Appropriate evaluation and management CPT code].