L97.224
BillableNon-pressure chronic ulcer of left calf 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 open sore on the left calf that is not caused by pressure, with dead bone tissue visible in the wound.
Coding Tips
- •Bone necrosis is the most severe category; verify documentation confirms bone involvement with necrosis
- •This typically requires specialist consultation and may indicate need for surgical intervention
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. Bone necrosis represents the most severe stage of chronic ulceration with osteomyelitis risk, frequently necessitating aggressive surgical intervention and reflecting profound underlying disease burden.
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 bone within or at the base of the wound
- ✓Imaging or clinical findings confirming bone necrosis (osteonecrosis)
- ✓Assessment for osteomyelitis with appropriate workup (imaging, labs, culture if indicated)
- ✓Surgical consultation documentation if applicable
Commonly Confused Codes
L97.223 — necrosis of muscle; muscle tissue death is presentL97.226 — bone involvement without necrosis; bone exposed but viable, no necrosisL97.124 — 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
Code Hierarchy
└L97Non-pressure chronic ulcer of lower limb, not elsewhere classified└L97.2Non-pressure chronic ulcer of calf└L97.22Non-pressure chronic ulcer of left calf└L97.224Non-pressure chronic ulcer of left calf with necrosis of bone
└L97.224Non-pressure chronic ulcer of left calf with necrosis of bone