L97.821

L97.821: Non-pressure chronic ulcer of other part of left lower leg limited to breakdown of skin

Billable / specific codeICD-10-CMleft

L97.821 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of other part of left lower leg limited to breakdown of skin. It is valid for submission on a claim.

Check L97.821 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above L97.821

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

L97.821 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

L97.821 is named in 12 Medicare coverage policies: 10 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
A52993Billing and Coding: Peripheral Venous Ultrasound
A53065Billing and Coding: Outpatient Physical Therapy

Alphabetic index entries that lead here

Ulcer, ulcerated, ulcerating, ulceration, ulcerative›lower limb›lower leg NOS›specified site NEC›left›with›skin breakdown only

Code history

Unchanged in every release from FY2024 to FY2027.