L92.1
BillableNecrobiosis lipoidica, not elsewhere classified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is L92.1 an HCC code?
No. L92.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
L92.1 is the ICD-10-CM diagnosis code for necrobiosis lipoidica, not elsewhere classified. A chronic skin condition characterized by shiny, reddish patches typically on the lower legs, caused by abnormal tissue death and fat degeneration in the skin. L92.1 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering other disorders of the skin and subcutaneous tissue (l80-l99).
L92.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the specific location of necrobiosis lipoidica lesions, as this condition commonly affects the anterior tibial region.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L92.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific location of necrobiosis lipoidica lesions, as this condition commonly affects the anterior tibial region
- •Distinguish from other granulomatous conditions and ensure this code is used only when the condition is not classified elsewhere