L97.113

L97.113: Non-pressure chronic ulcer of right thigh with necrosis of muscle

Billable / specific codeICD-10-CMright

L97.113 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of right thigh with necrosis of muscle. It is valid for submission on a claim.

Check L97.113 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above L97.113

Not part of this code, but both may be coded when both are present.

Written on L97: Non-pressure chronic ulcer of lower limb, not elsewhere classified

pressure ulcer (pressure area) (L89.-)
skin infections (L00-L08)
specific infections classified to A00-B99

Risk adjustment

L97.113 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 380 Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle1.078 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

L97.113 is named in 15 Medicare coverage policies: 15 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52993Billing and Coding: Peripheral Venous Ultrasound
A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53064Billing and Coding: Outpatient Occupational Therapy

Alphabetic index entries that lead here

Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›thigh›right›with›muscle necrosis

Code history

Unchanged in every release from FY2024 to FY2027.