L98.A193 — Non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle
L98.A193 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle. It is valid for submission on a claim.
Excludes2 inherited from the categories above L98.A193
Also inherited, and the opposite of Excludes1: these conditions are not part of L98.A193, but a patient can have both, so you may code both.
Risk adjustment
L98.A193 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.A193 is named in 4 Medicare coverage policies — 4 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.A193 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.A193.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›upper limb›upper arm›with›muscle necrosis
Code history
What changed, and when. Derived by diffing consecutive CMS release files — which matters when you are defending a code assigned under an earlier edition.
- addedFY2024-FY2026
Non-pressure chronic ulcer of unspecified upper arm with necrosis of muscle
Related codes at this level
Codes that share L98.A19. If L98.A193 is not quite right, the correct code is usually one of these.
- L98.A191Non-pressure chronic ulcer of unspecified upper arm limited to breakdown of skin
- L98.A192Non-pressure chronic ulcer of unspecified upper arm with fat layer exposed
- L98.A194Non-pressure chronic ulcer of unspecified upper arm with necrosis of bone
- L98.A195Non-pressure chronic ulcer of unspecified upper arm with muscle involvement without evidence of necrosis
- L98.A196Non-pressure chronic ulcer of unspecified upper arm with bone involvement without evidence of necrosis
- L98.A198Non-pressure chronic ulcer of unspecified upper arm with other specified severity
- L98.A199Non-pressure chronic ulcer of unspecified upper arm with unspecified severity
Questions about L98.A193
- Is L98.A193 a billable ICD-10-CM code?
- Yes. L98.A193 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L98.A193 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).