L97.811

Billable

Non-pressure chronic ulcer of other part of right lower leg limited to breakdown of skin

HCC Category Mapping

V28HCC 383 — Diabetic Skin Ulcer and Severe Skin Conditions

0.517

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 right lower leg (not caused by pressure) where only the outer layer of skin is damaged.

Coding Tips

•Confirm laterality is right leg and location is lower leg to support this specific code
•This represents the least severe stage; if deeper tissue involvement is present, use a higher severity code (L97.812-L97.819)

Clinical Significance

This non-pressure chronic ulcer on the other part of right lower leg limited to skin breakdown represents the earliest stage of chronic ulceration, but still indicates impaired wound healing requiring clinical intervention. 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 right lower leg
✓Laterality documented as right side
✓Wound assessment confirming ulcer is limited to skin breakdown only (epidermis/dermis)
✓No exposure of subcutaneous fat, muscle, or bone
✓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

L97.821 — Left lower leg equivalent; confirm laterality before coding L97.812 — fat layer exposed — deeper involvement than skin-only breakdown L97.819 — unspecified severity — use skin breakdown code when depth is documented 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 └L97.81Non-pressure chronic ulcer of other part of right lower leg └L97.811Non-pressure chronic ulcer of other part of right lower leg limited to breakdown of skin

└L97.811Non-pressure chronic ulcer of other part of right lower leg limited to breakdown of skin