L98.494 — Non-pressure chronic ulcer of skin of other sites with necrosis of bone
L98.494 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of skin of other sites with necrosis of bone. It is valid for submission on a claim.
Risk adjustment
L98.494 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
L98.494 is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A55909Billing and Coding: Wound Care
How L98.494 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 L98.494.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›skin›specified site NEC›with›bone necrosis
Related codes at this level
Codes that share L98.49. If L98.494 is not quite right, the correct code is usually one of these.
- L98.491Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin
- 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
- L98.495Non-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
Questions about L98.494
- Is L98.494 a billable ICD-10-CM code?
- Yes. L98.494 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L98.494 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).