L97.104
BillableNon-pressure chronic ulcer of unspecified thigh with necrosis of bone
HCC Category Mapping
V28HCC 380 — Chronic Ulcer of Skin, Except Pressure
0.426V24HCC 161 — Chronic Ulcer of Skin, Except Pressure
0.426ESRDHCC 161 — Chronic Ulcer of Skin, Except Pressure
0.000RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer
0.000What This Code Means
A long-lasting, non-pressure-related wound on the thigh that has penetrated deep enough to cause death of bone tissue.
Coding Tips
- •This is the most severe category indicating bone necrosis; typically requires imaging confirmation
- •Distinguish from L97.106 which indicates bone involvement without necrosis
Clinical Significance
A non-pressure chronic ulcer of the unspecified thigh with necrosis of bone represents a deep, non-healing wound involving structures beyond the subcutaneous tissue. These ulcers typically result from peripheral vascular disease, venous insufficiency, or other systemic conditions, and indicate significant tissue destruction requiring complex wound management. Deep non-pressure chronic ulcers map to V28 HCC 380 (Chronic Ulcer of Skin, Except Pressure) with a RAF of 0.426, reflecting the substantial clinical resources needed for management.
Documentation Requirements
- ✓Exact anatomical location with laterality (right, left, or bilateral thigh)
- ✓Etiology of the ulcer (venous insufficiency, peripheral arterial disease, neuropathic, post-traumatic, other)
- ✓Wound dimensions: length x width x depth in centimeters
- ✓Documentation of involved structures (muscle, bone, tendon) with or without necrosis
- ✓Wound bed description including percentage of granulation, slough, eschar, and necrotic tissue
- ✓Presence of undermining, tunneling, or sinus tracts with measurements
- ✓Vascular assessment results (ankle-brachial index, duplex ultrasound)
- ✓Current wound care plan including debridement method, dressing type, and frequency
- ✓Signs of infection (cellulitis, osteomyelitis, positive wound cultures)
- ✓Chronicity documentation — duration of wound and treatment history
- ✓Contributing comorbidities (diabetes mellitus, peripheral vascular disease, malnutrition)
Commonly Confused Codes
L97.114 — Non-pressure chronic ulcer of right thigh, same severity; assign when laterality is documented as rightL97.124 — Non-pressure chronic ulcer of left thigh, same severity; assign when laterality is documented as leftL89.894 — Pressure ulcer of other site requires pressure as the etiology, not vascular or other causesL97.9xx — Non-pressure chronic ulcer of unspecified site should not be used for thigh when thigh is documented
Code Hierarchy
└L97Non-pressure chronic ulcer of lower limb, not elsewhere classified└L97.1Non-pressure chronic ulcer of thigh└L97.10Non-pressure chronic ulcer of unspecified thigh└L97.104Non-pressure chronic ulcer of unspecified thigh with necrosis of bone
└L97.104Non-pressure chronic ulcer of unspecified thigh with necrosis of bone