What is ICD-10 code L97.524?

L97.524 is the ICD-10-CM diagnosis code for Non-pressure chronic ulcer of other part of left foot with necrosis of bone. A long-lasting open sore on the left foot (not from pressure) where the bone tissue has died or deteriorated. L97.524 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L97.524 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. L97.524 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. L97.524 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for L97.524?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For L97.524, V28 maps to Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle at RAF 1.078 while V24 mapped to Chronic Ulcer of Skin, Except Pressure at RAF 0.515. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting L97.524?

This is one of the most severe non-pressure ulcer codes; confirm bone necrosis in documentation Distinguish from L97.526 which indicates bone involvement without necrosis Because L97.524 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM L97.524: Non-pressure chronic ulcer

ICD-10-CM Code View

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Code lookupL97.524Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)

L97.524

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Non-pressure chronic ulcer of other part of left foot with necrosis of bone

A long-lasting open sore on the left foot (not from pressure) where the bone tissue has died or deteriorated.

Buddy Insight

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.

CMS-HCC V28

Mapped

HCC 380

Chronic Ulcer of Skin, Except...

RAF 1.078

CMS-HCC V24

Mapped

HCC 161

Chronic Ulcer of Skin, Except...

RAF 0.515

ACA/HHS

Mapped

HCC 217

HHS-HCC 217

Varies by metal level

ESRD/PACE

Mapped

HCC 161

Chronic Ulcer of Skin, Except...

RAF 0.127

RXHCC

Mapped

HCC 311

Diabetic and Chronic Skin Ulcer

RAF 0.175

Code Book Path

Official

L97.5Non-pressure chronic ulcer of other part of foot

L97.52Non-pressure chronic ulcer of other part of left foot

L97.524Non-pressure chronic ulcer of other part of left foot with necrosis of bone

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L97.524 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L97.524 in this effective period.

Related Child Codes

Official

L97.521Non-pressure chronic ulcer of other part of left foot limited to breakdown of skin

L97.522Non-pressure chronic ulcer of other part of left foot with fat layer exposed

L97.523Non-pressure chronic ulcer of other part of left foot with necrosis of muscle

L97.525Non-pressure chronic ulcer of other part of left foot with muscle involvement without evidence of necrosis

L97.526Non-pressure chronic ulcer of other part of left foot with bone involvement without evidence of necrosis

Includes

Official

ICD-10-CM does not list Includes notes for L97.524 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L97.524 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L97.524 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L97.524 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L97.524 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Specific anatomic location documented as other part of left foot

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)

MEAT Support

HCC Buddy guidance

Specific anatomic location documented as other part of left foot

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)

Audit Caution

HCC Buddy guidance

Confusing non-pressure ulcers (L97) with pressure ulcers (L89) — verify the etiology is NOT pressure/immobility-related before assigning L97 codes

Failing to obtain imaging confirmation of bone necrosis — clinical documentation should be supported by radiologic evidence when possible

Confusing bone involvement with bone necrosis — bone exposure does not automatically mean the bone is necrotic

Failing to code the underlying cause (diabetes, peripheral vascular disease, venous insufficiency) — L97 codes often require an additional etiology code per ICD-10-CM guidelines

Common Mistakes

HCC Buddy guidance

L97.526 — Bone involvement WITHOUT necrosis at same location; use when bone is exposed but viable

L97.523 — Necrosis of MUSCLE at same location; use when muscle (not bone) shows necrosis

L89.xxx (Pressure ulcer codes) — Pressure ulcers use the L89 category; L97 is specifically for NON-pressure chronic ulcers

L97.514 — Same severity but RIGHT side; verify laterality matches documentation

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is L97.524 an HCC code?

Yes. L97.524 (Non-pressure chronic ulcer of other part of left foot with necrosis of bone) maps to Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle under the CMS-HCC V28 risk adjustment model (and Chronic Ulcer of Skin, Except Pressure under V24), with a community non-dual aged RAF of 1.078. It is billable for payment year 2026.

Coder answer: L97.524 is billable and maps to V28 HCC 380, Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: L97.524
Description: Non-pressure chronic ulcer of other part of left foot with necrosis of bone
HCC (V28): HCC 380 — Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle
RAF: 1.078
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 380, Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle

1.078

V24HCC 161, Chronic Ulcer of Skin, Except Pressure

0.515

ESRDHCC 161, Chronic Ulcer of Skin, Except Pressure

0.127

RxHCCHCC 311, Diabetic and Chronic Skin Ulcer

0.175

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work L97.524 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for L97.524

For L97.524 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed L97.524 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

L97.524 is the ICD-10-CM diagnosis code for non-pressure chronic ulcer of other part of left foot with necrosis of bone. A long-lasting open sore on the left foot (not from pressure) where the bone tissue has died or deteriorated. L97.524 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering other disorders of the skin and subcutaneous tissue (l80-l99).

Under the CMS-HCC V28 risk adjustment model, L97.524 maps to Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle (HCC 380) with a community, non-dual, aged base RAF weight of 1.078. Under the older CMS-HCC V24 model, L97.524 maps to Chronic Ulcer of Skin, Except Pressure (HCC 161) with a community, non-dual, aged base RAF weight of 0.515. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

This is one of the most severe non-pressure ulcer codes; confirm bone necrosis in documentation. Because L97.524 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L97.524 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is one of the most severe non-pressure ulcer codes; confirm bone necrosis in documentation
•Distinguish from L97.526 which indicates bone involvement without 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 other part of foot) is essential for proper code assignment and tracking wound progression over time.

Documentation Requirements

✓Specific anatomic location documented as other part of left foot
✓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

•L97.526: Bone involvement WITHOUT necrosis at same location; use when bone is exposed but viable
•L97.523: Necrosis of MUSCLE at same location; use when muscle (not bone) shows necrosis
•L89.xxx (Pressure ulcer codes): Pressure ulcers use the L89 category; L97 is specifically for NON-pressure chronic ulcers
•L97.514: Same severity but RIGHT side; verify laterality matches documentation
•E11.621 (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