L97.225
BillableNon-pressure chronic ulcer of left calf with muscle involvement without evidence of necrosis
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 muscle tissue involved but not yet dead.
Coding Tips
- •Distinguish this from code 223 by confirming muscle involvement WITHOUT necrosis
- •Document the extent of muscle involvement to support medical necessity for 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. Muscle involvement without necrosis indicates the ulcer extends to muscle tissue that remains viable, representing a serious wound that requires close monitoring to prevent progression to tissue death.
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 that muscle tissue is exposed or involved but remains viable
- ✓Explicit statement that no necrosis of muscle is present
- ✓Wound bed description distinguishing viable muscle from necrotic tissue
Commonly Confused Codes
L97.223 — necrosis of muscle; muscle tissue death is presentL97.222 — fat layer exposed; extends through dermis to subcutaneous fatL97.125 — 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