L97.111 — Non-pressure chronic ulcer of right thigh limited to breakdown of skin
L97.111 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of right thigh limited to breakdown of skin. It is valid for submission on a claim.
Risk adjustment
L97.111 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 383 Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle0.646 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
L97.111 is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52993Billing and Coding: Peripheral Venous Ultrasound
- A53065Billing and Coding: Outpatient Physical Therapy
- A55909Billing and Coding: Wound Care
- A56459Billing and Coding: Debridement Services
How L97.111 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to L97.111.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›thigh›right›with›skin breakdown only
Related codes at this level
Codes that share L97.11. If L97.111 is not quite right, the correct code is usually one of these.
- L97.112Non-pressure chronic ulcer of right thigh with fat layer exposed
- L97.113Non-pressure chronic ulcer of right thigh with necrosis of muscle
- L97.114Non-pressure chronic ulcer of right thigh with necrosis of bone
- L97.115Non-pressure chronic ulcer of right thigh with muscle involvement without evidence of necrosis
- L97.116Non-pressure chronic ulcer of right thigh with bone involvement without evidence of necrosis
- L97.118Non-pressure chronic ulcer of right thigh with other specified severity
- L97.119Non-pressure chronic ulcer of right thigh with unspecified severity
Questions about L97.111
- Is L97.111 a billable ICD-10-CM code?
- Yes. L97.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L97.111 sit in the tabular list?
- Diseases of the skin and subcutaneous tissue (L00-L99), in the block Other disorders of the skin and subcutaneous tissue (L80-L99).