Ulceroglandular tularemia

This code describes a specific form of tularemia characterized by both glandular involvement (lymphadenopathy) and ulceration at the site of inoculation. It represents a bacterial zoonotic infection caused by Francisella tularensis, typically acquired through contact with infected animals or insect bites.

Use this code when documentation clearly indicates a diagnosis of tularemia presenting with both an ulcer and regional lymph node enlargement. This is often seen following direct contact with infected animal tissue or a bite from an infected arthropod. Supporting documentation would include physician notes detailing the characteristic ulcer and palpable lymphadenopathy, along with positive diagnostic tests for F. tularensis.

• Differentiate from other forms of tularemia (e.g., oculoglandular, typhoidal) which have distinct ICD-9-CM codes.
• Ensure the documentation explicitly mentions both "ulcer" and "glandular" involvement to support this specific subtype.
• Sequence this code as the primary diagnosis when it is the reason for the encounter.