L97.324
BillableNon-pressure chronic ulcer of left ankle 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 ankle that is not caused by pressure, with dead bone tissue present.
Coding Tips
- •Confirm bone necrosis is documented; this is one of the most severe non-pressure ulcer stages
- •Ensure imaging or clinical assessment confirms bone involvement and necrosis
Clinical Significance
This is one of the most severe classifications of non-pressure chronic ulcers, with bone necrosis indicating full-thickness tissue destruction reaching the skeletal level. Bone necrosis (osteonecrosis) carries high risk for osteomyelitis and may require surgical intervention including possible amputation. Accurate laterality documentation (left ankle) is essential for proper code assignment and tracking wound progression over time.
Documentation Requirements
- ✓Specific anatomic location documented as left ankle
- ✓Confirmation that the ulcer is non-pressure in etiology (not caused by pressure/immobility)
- ✓Chronicity established — ulcer present for extended duration or described as chronic
- ✓Current wound assessment including size (length x width x depth in centimeters)
- ✓Explicit documentation of bone necrosis (dead/devitalized bone tissue)
- ✓Imaging studies (X-ray, MRI, or bone scan) confirming bone involvement and necrosis
- ✓Assessment for osteomyelitis
- ✓Wound debridement or surgical notes if applicable
- ✓Underlying etiology or contributing factors (diabetes, peripheral vascular disease, venous insufficiency)
- ✓Current treatment plan including wound care regimen
Commonly Confused Codes
L97.326 — Bone involvement WITHOUT necrosis at same location; use when bone is exposed but viableL97.323 — Necrosis of MUSCLE at same location; use when muscle (not bone) shows necrosisL89.xxx (Pressure ulcer codes) — Pressure ulcers use the L89 category; L97 is specifically for NON-pressure chronic ulcersL97.314 — Same severity but RIGHT side; verify laterality matches documentationE11.621 (Type 2 diabetes mellitus with foot ulcer) — If ulcer is due to diabetes, code the diabetic complication first and the L97 code as an additional code to specify site and severity
Code Hierarchy
└L97Non-pressure chronic ulcer of lower limb, not elsewhere classified└L97.3Non-pressure chronic ulcer of ankle└L97.32Non-pressure chronic ulcer of left ankle└L97.324Non-pressure chronic ulcer of left ankle with necrosis of bone
└L97.324Non-pressure chronic ulcer of left ankle with necrosis of bone