L97.504 — Non-pressure chronic ulcer of other part of unspecified foot with necrosis of bone
L97.504 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of other part of unspecified foot with necrosis of bone. It is valid for submission on a claim.
Risk adjustment
L97.504 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.
Medicare coverage
L97.504 is named in 3 Medicare coverage policies — 1 listing it as supporting medical necessity, and 2 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
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A53057Billing and Coding: Home Health Occupational Therapy
How L97.504 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 L97.504.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›foot specified NEC›with›bone necrosis
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›toe›with›bone necrosis
Related codes at this level
Codes that share L97.50. If L97.504 is not quite right, the correct code is usually one of these.
- L97.501Non-pressure chronic ulcer of other part of unspecified foot limited to breakdown of skin
- L97.502Non-pressure chronic ulcer of other part of unspecified foot with fat layer exposed
- L97.503Non-pressure chronic ulcer of other part of unspecified foot with necrosis of muscle
- L97.505Non-pressure chronic ulcer of other part of unspecified foot with muscle involvement without evidence of necrosis
- L97.506Non-pressure chronic ulcer of other part of unspecified foot with bone involvement without evidence of necrosis
- L97.508Non-pressure chronic ulcer of other part of unspecified foot with other specified severity
- L97.509Non-pressure chronic ulcer of other part of unspecified foot with unspecified severity
Questions about L97.504
- Is L97.504 a billable ICD-10-CM code?
- Yes. L97.504 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L97.504 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).