L97.226
BillableNon-pressure chronic ulcer of left calf with bone 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 bone tissue involved but not yet dead.
Coding Tips
- •Confirm bone involvement is present but necrosis is absent to differentiate from code 224
- •This severity level typically warrants specialist evaluation and imaging studies
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 involvement without necrosis indicates deep ulceration exposing viable bone, which carries high risk for osteomyelitis and typically requires specialized wound care and possible surgical management.
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 bone is exposed or involved but remains viable
- ✓Explicit statement that no bone necrosis is present
- ✓Assessment for osteomyelitis risk even without current necrosis
- ✓Imaging results if performed to evaluate bone involvement
Commonly Confused Codes
L97.224 — necrosis of bone; bone tissue death — most severeL97.228 — other specified severity; severity documented but not fitting standard categoriesL97.126 — 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└L97.226Non-pressure chronic ulcer of left calf with bone involvement without evidence of necrosis
└L97.226Non-pressure chronic ulcer of left calf with bone involvement without evidence of necrosis