L97.525

Billable

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

HCC Category Mapping

V28HCC 380 — Chronic Ulcer of Skin, Except Pressure

0.426

V24HCC 161 — Chronic Ulcer of Skin, Except Pressure

0.426

ESRDHCC 161 — Chronic Ulcer of Skin, Except Pressure

0.000

RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer

0.000

What This Code Means

A long-lasting open sore on the left foot (not from pressure) that involves muscle tissue but shows no dead tissue.

Coding Tips

•Muscle is involved but viable (not necrotic); this is less severe than L97.523
•Ensure documentation confirms muscle layer involvement without necrosis

Clinical Significance

This non-pressure chronic ulcer on the other part of left foot with viable muscle involvement indicates deep tissue penetration without active tissue death, suggesting the wound is severe but potentially salvageable with aggressive wound care. Chronic non-pressure ulcers are significant for risk adjustment because they indicate ongoing complex wound management needs, increased healthcare utilization, and often reflect underlying systemic conditions such as peripheral vascular disease, diabetes mellitus, or venous insufficiency. Accurate severity coding directly impacts care planning, specialist referral decisions, and appropriate resource allocation for wound care services.

Documentation Requirements

✓Confirmation that the ulcer is chronic (present for extended duration, not acute)
✓Documentation that the ulcer is NOT caused by pressure (non-pressure etiology)
✓Specific anatomical site of the ulcer on the other part of left foot
✓Laterality documented as left side
✓Wound assessment confirming muscle layer involvement
✓Explicit documentation that muscle tissue is viable (no necrosis present)
✓Description of wound depth extending to but not destroying muscle
✓Underlying etiology or contributing conditions (e.g., venous insufficiency, arterial disease, diabetes mellitus, neuropathy)
✓Current wound measurements (length, width, depth) and wound bed description
✓Current treatment plan and wound care management

Commonly Confused Codes

L97.515 — Right foot equivalent; verify laterality documentation carefully L97.523 — muscle necrosis — this code requires necrosis (tissue death) to be present L97.522 — fat layer exposed — less deep, does not involve muscle L89.xxx — Pressure ulcer codes; L97 is specifically for NON-pressure chronic ulcers L97.8xx — Lower leg ulcer codes; verify whether the ulcer is on the foot or leg

Code Hierarchy

└L97Non-pressure chronic ulcer of lower limb, not elsewhere classified └L97.5Non-pressure chronic ulcer of other part of foot └L97.52Non-pressure chronic ulcer of other part of left foot └L97.525Non-pressure chronic ulcer of other part of left foot with muscle involvement without evidence of necrosis

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