L97.806

Billable

Non-pressure chronic ulcer of other part of unspecified lower leg with bone 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 lower leg (not caused by pressure) where bone tissue is involved but has not died.

Coding Tips

•This code indicates bone involvement without necrosis; differentiate from L97.804 which includes bone death
•Imaging studies should document bone involvement to justify this code selection

Clinical Significance

This non-pressure chronic ulcer on the other part of unspecified lower leg with viable bone involvement indicates the ulcer has reached bone without causing osteonecrosis, representing a critical window where intervention may prevent bone death. 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 unspecified lower leg
✓Query provider for laterality if not documented (left vs. right)
✓Wound assessment confirming bone involvement/exposure
✓Explicit documentation that bone is viable (no necrosis present)
✓Imaging studies confirming bone involvement without osteonecrosis
✓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

L97.804 — bone necrosis — this code requires necrosis (tissue death) to be present L97.805 — muscle involvement without necrosis — less deep, does not involve bone L89.xxx — Pressure ulcer codes; L97 is specifically for NON-pressure chronic ulcers L97.5xx — Foot ulcer codes; verify whether the ulcer is on the leg or foot

Code Hierarchy

└L97Non-pressure chronic ulcer of lower limb, not elsewhere classified └L97.8Non-pressure chronic ulcer of other part of lower leg └L97.80Non-pressure chronic ulcer of other part of unspecified lower leg └L97.806Non-pressure chronic ulcer of other part of unspecified lower leg with bone involvement without evidence of necrosis

└L97.806Non-pressure chronic ulcer of other part of unspecified lower leg with bone involvement without evidence of necrosis