L98.A111 — Non-pressure chronic ulcer of right upper arm limited to breakdown of skin
L98.A111 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of right upper arm limited to breakdown of skin. It is valid for submission on a claim.
Risk adjustment
L98.A111 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
L98.A111 is named in 6 Medicare coverage policies — 6 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
- A53065Billing and Coding: Outpatient Physical Therapy
How L98.A111 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.A111.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›upper limb›upper arm›right›with›skin breakdown only
Related codes at this level
Codes that share L98.A11. If L98.A111 is not quite right, the correct code is usually one of these.
- L98.A112Non-pressure chronic ulcer of right upper arm with fat layer exposed
- L98.A113Non-pressure chronic ulcer of right upper arm with necrosis of muscle
- L98.A114Non-pressure chronic ulcer of right upper arm with necrosis of bone
- L98.A115Non-pressure chronic ulcer of right upper arm with muscle involvement without evidence of necrosis
- L98.A116Non-pressure chronic ulcer of right upper arm with bone involvement without evidence of necrosis
- L98.A118Non-pressure chronic ulcer of right upper arm with other specified severity
- L98.A119Non-pressure chronic ulcer of right upper arm with unspecified severity
Questions about L98.A111
- Is L98.A111 a billable ICD-10-CM code?
- Yes. L98.A111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L98.A111 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).