L97.223
BillableNon-pressure chronic ulcer of left calf with necrosis of muscle
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 open sore on the left calf that is not caused by pressure, with dead muscle tissue visible in the wound.
Coding Tips
- •Necrosis indicates tissue death; ensure clinical documentation explicitly states muscle necrosis
- •This represents a more severe ulcer requiring close monitoring and aggressive treatment
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. The presence of muscle necrosis indicates severe tissue destruction extending well beyond skin layers, often requiring surgical debridement and signaling significant vascular compromise or uncontrolled systemic disease.
Documentation Requirements
- ✓Ulcer site documented as left calf with clear laterality (left 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 of necrotic muscle tissue within the wound bed
- ✓Clinical or pathological confirmation of muscle necrosis (not just muscle exposure)
- ✓Wound measurements and staging consistent with deep tissue destruction
- ✓Treatment plan addressing debridement of necrotic muscle tissue
Commonly Confused Codes
L97.225 — muscle involvement without necrosis; muscle exposed but viable, no necrosisL97.224 — necrosis of bone; bone tissue death — most severeL97.123 — right 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