L97.408 — Non-pressure chronic ulcer of unspecified heel and midfoot with other specified severity
L97.408 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of unspecified heel and midfoot with other specified severity. It is valid for submission on a claim.
Risk adjustment
L97.408 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
L97.408 is named in 1 Medicare coverage policy — 0 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
How L97.408 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 L97.408.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›heel›with›specified severity NEC
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›midfoot›with›specified severity NEC
Related codes at this level
Codes that share L97.40. If L97.408 is not quite right, the correct code is usually one of these.
- L97.401Non-pressure chronic ulcer of unspecified heel and midfoot limited to breakdown of skin
- L97.402Non-pressure chronic ulcer of unspecified heel and midfoot with fat layer exposed
- L97.403Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of muscle
- L97.404Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of bone
- L97.405Non-pressure chronic ulcer of unspecified heel and midfoot with muscle involvement without evidence of necrosis
- L97.406Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis
- L97.409Non-pressure chronic ulcer of unspecified heel and midfoot with unspecified severity
Questions about L97.408
- Is L97.408 a billable ICD-10-CM code?
- Yes. L97.408 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L97.408 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).