Left BKA ICD-10 Code: Z89.512

The ICD-10 code for left BKA (below knee amputation) status is Z89.512 (Acquired absence of left leg below knee). This is a status code indicating the patient has had a previous amputation - it's not used to code the amputation procedure itself.

Status Code vs. Procedure Code

This is a critical distinction that trips up many coders:

Z89.512 is never the primary diagnosis for an amputation surgery - it's used in subsequent encounters to document the patient's amputation status.

Z89.5 Code Family

ICD-10-CM provides laterality-specific codes for below-knee amputations:

Always code to the highest level of specificity. If laterality is documented (and it almost always is), use the specific code rather than Z89.519.

Common Coding Scenarios

Scenario 1: Routine Follow-Up for BKA

Documentation: "Follow-up for left BKA performed 6 weeks ago. Stump healing well. Prosthetic fitting evaluation."

Code: Z89.512 (Acquired absence of left leg below knee)

Rationale: The amputation status is the reason for the visit. This is appropriate as primary diagnosis for routine prosthetic-related visits.

Scenario 2: Stump Complication

Documentation: "Left BKA stump with wound dehiscence requiring revision."

Codes:

• T87.34 (Dehiscence of amputation stump, left lower extremity)
• Z89.512 (Acquired absence of left leg below knee)

Rationale: Sequence the complication first as the reason for the encounter. The status code provides context.

Scenario 3: Unrelated Admission with BKA History

Documentation: "Admission for pneumonia. PMH: Left BKA for PVD, diabetes."

Codes:

• J18.9 (Pneumonia, unspecified) - primary
• Z89.512 - if amputation status affects care (mobility, fall risk, etc.)

Rationale: Only include Z89.512 if the amputation status is relevant to the current encounter. Don't code it just because it's in the history.

Scenario 4: Coding the Amputation Procedure

Documentation: "Operative report: Left below-knee amputation for gangrene."

For the admission where the amputation is performed, code:

• The condition requiring amputation (I96, E11.52, etc.) as primary diagnosis
• ICD-10-PCS procedure code for the amputation
• Do NOT code Z89.512 during the operative admission - the status code applies to subsequent encounters

BKA vs. AKA Codes

Don't confuse below-knee and above-knee codes:

Documentation Tips

When documenting amputation status:

• Specify laterality - left vs. right
• Specify level - below knee, above knee, partial foot, etc.
• Note if relevant to current care - affects mobility, wound healing, prosthetic use