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v1.0.0
ICD-10 Guide
ICD-10 CodesN49.3

N49.3

Billable

Fournier gangrene

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/18/2025

Code Description

ICD-10 N49.3 is a billable code used to indicate a diagnosis of fournier gangrene.

Key Diagnostic Point:

Fournier gangrene is a severe, rapidly progressing necrotizing fasciitis that primarily affects the perineal, genital, and perianal regions. It is characterized by the presence of polymicrobial infections, often involving both aerobic and anaerobic bacteria. The condition typically presents with severe pain, swelling, erythema, and systemic signs of infection such as fever and tachycardia. Risk factors include diabetes mellitus, immunosuppression, obesity, and previous surgical procedures in the genital area. Early diagnosis and aggressive surgical intervention, including debridement of necrotic tissue, are critical for improving outcomes. Antibiotic therapy is also essential, targeting the polymicrobial nature of the infection. Complications can include sepsis, organ failure, and significant morbidity, including loss of genital structures. The management of Fournier gangrene requires a multidisciplinary approach, often involving urologists, surgeons, and infectious disease specialists.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Polymicrobial nature of the infection complicates diagnosis and treatment.
  • Requires detailed documentation of surgical interventions and antibiotic regimens.
  • Potential for rapid deterioration necessitates timely coding.
  • Associated with multiple comorbidities that may affect coding.

Audit Risk Factors

  • Inadequate documentation of the extent of tissue necrosis.
  • Failure to document comorbid conditions that may contribute to the severity.
  • Lack of clarity in the surgical notes regarding the procedures performed.
  • Inconsistent coding of associated infections or complications.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed surgical notes, including extent of debridement and any reconstructive procedures.

Common Clinical Scenarios

Management of Fournier gangrene in diabetic patients or post-surgical infections.

Billing Considerations

Need for clear documentation of the patient's baseline health status and any pre-existing conditions.

Infectious Disease

Documentation Requirements

Comprehensive records of antibiotic therapy and response to treatment.

Common Clinical Scenarios

Consultation for severe infections in immunocompromised patients.

Billing Considerations

Documentation of the microbiological findings and rationale for antibiotic choices.

Coding Guidelines

Inclusion Criteria

Use N49.3 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the clinical presentation, treatment, and any associated conditions
  • Include details on the extent of necrosis and any surgical interventions performed

Exclusion Criteria

Do NOT use N49.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

49020CPT Code

Exploratory laparotomy, peritoneal cavity

Clinical Scenario

Used in cases where Fournier gangrene leads to intra-abdominal complications.

Documentation Requirements

Document the indication for surgery and findings during the procedure.

Specialty Considerations

Urologists should ensure clear communication with surgical teams regarding the extent of the disease.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Fournier gangrene, improving the ability to capture the complexity of the condition and its management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Fournier gangrene, improving the ability to capture the complexity of the condition and its management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of Fournier gangrene, improving the ability to capture the complexity of the condition and its management.

Resources

Clinical References

  • •
    Fournier Gangrene: A Review

Coding & Billing References

  • •
    Fournier Gangrene: A Review

Frequently Asked Questions

What are the common risk factors for Fournier gangrene?

Common risk factors include diabetes mellitus, immunosuppression, obesity, and prior surgical procedures in the genital area.