L97.212
BillableNon-pressure chronic ulcer of right calf with fat layer exposed
HCC Category Mapping
V28HCC 383 — Diabetic Skin Ulcer and Severe Skin Conditions
0.517V24HCC 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 open sore on the right calf that is not caused by pressure, where the fatty tissue layer beneath the skin is exposed.
Coding Tips
- •Document that subcutaneous fat is visible but muscle is not involved
- •Distinguish from L97.213 which involves muscle necrosis
Clinical Significance
Non-pressure chronic ulcers of the lower extremity are significant indicators of underlying vascular disease, diabetes, or other systemic conditions that impair wound healing. Exposure of the fat layer indicates the ulcer has penetrated beyond the dermis into subcutaneous tissue, representing a moderate-severity wound with increased risk of infection and delayed healing.
Documentation Requirements
- ✓Ulcer site documented as right calf with clear laterality (right side)
- ✓Confirmation that the ulcer is chronic (present for extended duration, not acute)
- ✓Etiology documented as non-pressure (e.g., venous stasis, arterial insufficiency, diabetic, or other non-pressure cause)
- ✓Clinical assessment of wound depth and tissue involvement
- ✓Documentation that subcutaneous fat layer is visible or exposed in the wound bed
- ✓Wound measurements (length, width, depth) consistent with full-thickness skin loss
- ✓Description of wound bed appearance confirming fat tissue exposure
Commonly Confused Codes
L97.211 — limited to breakdown of skin; skin breakdown only — no deeper tissue involvementL97.215 — muscle involvement without necrosis; muscle exposed but viable, no necrosisL97.112 — left calf; verify laterality before selecting codeL89.- — Pressure ulcer codes; use only when ulcer is caused by sustained pressure, not vascular or other non-pressure etiology