L97.929 ICD-10-CM Code: Non-pressure chronic ulcer of unspecified part of left lower leg with unspecified severity

Code

L97.929

Description

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

HCC (V28)

HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

RAF reference coefficient

0.646

Billable

Yes

Payment year

2026

HCC Category Mapping

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work L97.929 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for L97.929

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for L97.929 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Query provider if severity is not documented; more specific codes (L97.921-L97.928) are preferred
• •Confirm non-pressure etiology and document underlying cause when possible

Clinical Significance

Non-pressure chronic ulcers of the left lower leg with unspecified severity represent a documentation gap that should trigger a provider query. While the code still maps to an HCC and contributes to risk adjustment, unspecified severity limits clinical utility and may not accurately reflect the patient's wound complexity. Coders should pursue additional documentation to assign a more specific severity code whenever possible.

Documentation Requirements

• ✓Provider documentation of the ulcer as chronic (present for extended duration, not acute)
• ✓Anatomical location clearly specified as left lower leg
• ✓Confirmation that the ulcer is non-pressure in etiology (e.g., venous, arterial, inflammatory, or other documented cause)
• ✓Description of wound bed characteristics and tissue involvement depth
• ✓Note: Unspecified severity indicates documentation gap — query provider for wound depth and tissue involvement details
• ✓Wound measurements (length, width, depth) and assessment of wound edges and surrounding tissue
• ✓Current treatment plan including wound care interventions

Commonly Confused Codes

• •L89.x: Pressure ulcer codes; use when ulcer is caused by sustained pressure (decubitus), not for non-pressure chronic ulcers
• •L97.921: Non-pressure chronic ulcer of left lower leg limited to skin breakdown; differs by severity level
• •L97.922: Non-pressure chronic ulcer of left lower leg with fat layer exposed; different depth of tissue involvement
• •L97.91x: Non-pressure chronic ulcer of right lower leg; differs by laterality (right vs. left)

Child Codes