ICD code T87.44 – Amputation stump infection, left lower extremity

Key takeaways

ICD-10 code T87.44 is a billable, specific code for infection of an amputation stump on the left lower extremity, valid for the current fiscal year.

The right leg has its own code, T87.43, so confirm the side in the record before you choose between them.

T87.4 is a non-billable header, so the claim needs the full code, T87.44.

Infection (T87.44) and necrosis (T87.54) are separate codes, and you report both when the provider documents both.

Pabau, our practice management platform, routes T87.44 claims to US payers through Claim.MD and posts remittances back to the patient record.

ICD-10 code T87.44 covers an infected left leg stump

ICD-10 code T87.44 is the code for infection of amputation stump, left lower extremity. You use it when a patient who has already lost part of the left leg, foot or toes develops an infection in the residual limb.

Most of the coding work comes down to two choices. The first is the side, because T87.43 is the right-leg twin. The second is the process, because necrosis without infection has a code of its own. The guide below takes both questions in order.

The code set updates every October 1. Check the current status in the CDC/NCHS ICD-10-CM web tool before you submit claims.

T87.44 sits under T87.4, a header you can’t bill

T87.44 is the last step in a short chain. Each level above it is a heading, and only the final code goes on a claim.

• Chapter 19 (S00-T88): Injury, poisoning and certain other consequences of external causes
• Block T80-T88: Complications of surgical and medical care, not elsewhere classified
• Category T87: Complications peculiar to reattachment and amputation (not billable)
• Subcategory T87.4: Infection of amputation stump (not billable)
• T87.44: Infection of amputation stump, left lower extremity (billable)

The CMS ICD-10-CM code files treat only complete codes as valid for billing. A claim that carries T87.4 comes back for more specificity, so it never reaches payment as sent.

T87.44 also takes no 7th character. Category T87 has no initial, subsequent or sequela extensions, so don’t add an A, D or S to it.

Left lower limb means T87.44, right means T87.43

The fifth character of T87.4x records the side and the limb. Here’s the full set, with T87.44 in bold.

If the provider’s note leaves the side out, check the rest of the record first. The official coding guidelines let you take laterality from other clinicians’ notes, such as nursing or wound care entries.

Query the provider only when the record is silent or contradicts itself. Fall back to T87.40 only when that query can’t settle it.

T87.44 vs T87.54: Infection and necrosis are coded apart

T87.44 records infection of the left lower extremity stump, and T87.54 records necrosis at the same site. Infection means an organism is driving inflammation. Necrosis means the tissue has died, and a stump can have one, the other or both.

Some stump problems need a different code

T87.44 covers one problem on one limb. These neighboring codes catch the conditions it leaves out, and mixing them up is a common audit flag.

The note has to say infection, left side and amputation

Most T87.44 problems start in the note rather than on the claim. Before you code, check that the provider has covered these four points, which also keeps each clean claim on track for first-pass acceptance.

1. Infection, in words. “Infection”, “abscess” or “cellulitis of the stump” supports the code. Drainage, redness or wound breakdown on their own don’t.
2. The left side, for this visit. The current note should name the left leg. A problem list carried forward from an old visit is weak support.
3. The prior amputation. A line on the level and date, such as “left below-knee amputation in March”, ties the infection to a residual limb.
4. Culture results, where you have them. A named organism, such as MRSA, strengthens the record and gets its own code. The clinical diagnosis still stands while a culture is pending.

How a T87.44 claim moves from visit to payment

Here’s the path a typical outpatient claim takes, and where each step can stall.

1. The provider documents the visit. The note names the infection, the left leg and the amputation level.
2. The coder assigns diagnosis codes. T87.44 goes first when the infection is the reason for the visit, followed by organism, limb-absence and comorbidity codes.
3. Procedure codes are added. Debridement, wound care or an office visit each point to T87.44 as the supporting diagnosis.
4. The claim is checked and sent. The clearinghouse checks format and required fields before the claim reaches the payer.
5. The payer adjudicates. Medical necessity rules, including any wound care LCD, decide whether the procedure lines pay.
6. The remittance comes back. A denial carries a reason code, which points you to the fix.

A worked example: An infected left below-knee stump

Take an illustrative patient with type 2 diabetes and peripheral artery disease. She had a left below-knee amputation eight months ago and now has redness, warmth and pus at the stump.

The provider documents “cellulitis of the left below-knee amputation stump”, and the culture grows MRSA. Here’s how the diagnosis lines read.

• T87.44 first, because the infection is the reason for the visit.
• B95.62 to name MRSA as the cause of the infection.
• Z89.512 for the acquired absence of the left leg below the knee.
• E11.51 for type 2 diabetes with diabetic peripheral angiopathy without gangrene.

If the provider later debrides dead tissue at the same site and documents necrosis, T87.54 joins the claim. That’s the dual-coding case from the comparison above.

Payer rules that shape a T87.44 claim

• Date-of-service documentation: The infection has to appear in the provider’s note for the date billed, not only in a carried-forward problem list.
• Place of service: Office visits use POS 11, on-campus hospital outpatient visits use POS 22 and inpatient stays use POS 21. The code on the claim must match the setting.
• Inpatient DRG impact: T87.44 is a CC under MS-DRG. As a secondary diagnosis it can raise an admission’s severity tier, unless a CC exclusion applies.
• External cause code: Y83.5 records amputation of a limb as the cause of a later complication. There’s no national requirement to report it, but some states and payers ask for it.
• Wound care LCDs: When T87.44 supports debridement codes such as 97597 or 97598, your MAC’s wound care LCD sets the documentation needed. Check it before you bill.

Before you submit: A T87.44 checklist

Run through these points before the claim leaves your system. Each one maps to a denial reason in the next section.

• The note says “infection” or a named equivalent, not only signs.
• This visit’s documentation names the left lower limb.
• The amputation level and approximate date are on record.
• The claim carries T87.44, not T87.4 or T87.40.
• Documented necrosis is coded separately as T87.54.
• An organism code is added when a culture identifies one.
• The Z89 code matches the amputation level and side.
• Each procedure line points to T87.44 as its diagnosis.
• The place of service matches where the visit happened.

Five mistakes that get T87.44 claims denied

Stump-infection denials follow a pattern, so fixing the cause beats reworking each remittance. Solid denial management workflows start with these five.

1. Unspecified laterality: T87.40 goes out when the record names the left leg. Payers treat it as incomplete coding and may return or deny the claim.
2. Signs without a diagnosis: “Drainage noted” or “redness around stump” doesn’t support T87.44. Work with providers on note templates that state the conclusion.
3. No link to the amputation: The note has to tie the wound to a residual limb. Without that, the payer may treat it as a general wound infection and ask for records.
4. Wrong sequencing: When the visit is for the stump infection, T87.44 is listed first. Placing it behind a comorbidity such as diabetes blurs the reason for care.
5. Infection and necrosis mixed up: Coding one as the other creates a mismatch that auditors flag. When both are present, report both, as described in the T87.44 vs T87.54 section above.

Our guide to denial codes in medical billing maps each claim adjustment reason code (CARC) back to a likely cause.

Codes that often travel with T87.44

T87.44 rarely sits alone on a claim. These codes often join it, from organism and limb-absence codes to the debridement lines it supports.

Some MACs list wound measurements and depth notes that must appear before 97597 or 97598 is covered on a stump wound. Confirm the LCD in your jurisdiction before you bill.

How Pabau keeps T87.44 claims moving

A stump-infection claim often depends on someone retyping the code, the side and the procedure lines from the note. Each retype is a chance to pick T87.43 by mistake or drop the necrosis code.

Pabau, the practice management platform we build, pre-fills the claim from the patient record. Diagnosis codes on the patient’s problem list seed the claim, and the built-in ICD-10-CM library lets you check T87.44’s siblings without leaving the screen. Required fields are checked before the claim can be sent.

In the US, Pabau sends claims to payers electronically through Claim.MD. Eligibility checks run before the visit, and remittances post back to the record. Our claims management software tracks each claim after submission, so your team sees which ones are paid, pending or denied.

Get stump-infection claims right first time

Pabau pre-fills claims from the patient record, checks required fields and sends them to US payers through Claim.MD. Remittances post back automatically, so denials surface fast.

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Conclusion

T87.44 comes down to two checks. Is it the left leg, and is it infection rather than necrosis? Get both right and the code itself seldom causes trouble.

The harder work happens upstream, in the note. A provider who writes “infection of the left below-knee stump” hands you a claim that holds up. A note that only says “drainage” sends you back for a query, and a delayed payment.

Pabau’s integration with Claim.MD’s clearinghouse carries that clean code through to payment and tracks each claim after it’s sent. Book a demo to see how Pabau handles stump-complication claims from note to remittance.

Continue your research

Want to see how clearinghouse edits catch errors before submission? Claim.MD clearinghouse guide explains how claims are checked against payer rules before they go out.

Looking for documentation standards that hold up on audit? Medical billing compliance guide covers the record-keeping that keeps claims audit-ready.

Curious how ICD-10 codes travel to payers? 837 file overview explains how diagnosis codes are carried in the 837P and 837I formats.

Record silent on the side even after a query? ICD-10 code T87.40 covers a stump infection on an unspecified extremity.

Wound opening along the suture line? ICD-10 code T87.81 covers dehiscence of an amputation stump.

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