L97.919

Billable

Non-pressure chronic ulcer of unspecified part of right lower leg with unspecified severity

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 chronic open sore on the right lower leg that is not caused by pressure, with the severity level not specified.

Coding Tips

•Verify the severity level in documentation; if specified, use a more specific code (L97.911-L97.918)
•Confirm the ulcer is non-pressure related and document the underlying cause (venous, arterial, diabetic, etc.)

Clinical Significance

This non-pressure chronic ulcer on the unspecified part of right lower leg with unspecified severity indicates incomplete wound assessment documentation, which limits care coordination and accurate risk stratification. 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 unspecified part of right lower leg
✓Laterality documented as right side
✓Note: This is an unspecified code — query provider for severity details when possible
✓If severity truly cannot be determined, document the reason
✓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

L97.929 — Left lower leg equivalent; confirm laterality before coding L97.911 — skin breakdown — if any severity detail is available, use the specific code instead L97.918 — other specified severity — use when severity is documented but atypical 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 └L97.9Non-pressure chronic ulcer of unspecified part of lower leg └L97.91Non-pressure chronic ulcer of unspecified part of right lower leg └L97.919Non-pressure chronic ulcer of unspecified part of right lower leg with unspecified severity

└L97.919Non-pressure chronic ulcer of unspecified part of right lower leg with unspecified severity