L98.491
L98.491: Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin
Billable / specific codeICD-10-CM
L98.491 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of skin of other sites limited to breakdown of skin. It is valid for submission on a claim.
Check L98.491 with the rest of the claim: free scrubberExcludes2 inherited from the categories above L98.491
Not part of this code, but both may be coded when both are present.
Risk adjustment
L98.491 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
L98.491 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55909Billing and Coding: Wound Care
- A56459Billing and Coding: Debridement Services
- A57221Billing and Coding: Plastic Surgery
- A58565Billing and Coding: Wound and Ulcer Care
Alphabetic index entries that lead here
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›skin›specified site NEC›with›skin breakdown only
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under L98.49
- L98.492Non-pressure chronic ulcer of skin of other sites with fat layer exposed
- L98.493Non-pressure chronic ulcer of skin of other sites with necrosis of muscle
- L98.494Non-pressure chronic ulcer of skin of other sites with necrosis of bone
- L98.495Non-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis
- L98.496Non-pressure chronic ulcer of skin of other sites with bone involvement without evidence of necrosis
- L98.498Non-pressure chronic ulcer of skin of other sites with other specified severity
- L98.499Non-pressure chronic ulcer of skin of other sites with unspecified severity