L98.414
BillableNon-pressure chronic ulcer of buttock with necrosis of bone
HCC Category Mapping
V28HCC 380 — Chronic Ulcer of Skin, Except Pressure
0.426V24HCC 161 — Chronic Ulcer of Skin, Except Pressure
0.426ESRDHCC 161 — Chronic Ulcer of Skin, Except Pressure
0.000RxHCCHCC 311 — Diabetic and Chronic Skin Ulcer
0.000What This Code Means
A chronic open sore on the buttock with the most severe damage, extending through all soft tissues and into the bone with dead bone tissue present.
Coding Tips
- •Confirm bone involvement through imaging (X-ray, MRI, or CT) and document evidence of bone necrosis
- •This code indicates severe osteomyelitis risk and typically requires aggressive treatment and specialist consultation
Clinical Significance
Non-pressure chronic ulcers of the buttock with necrosis represent severe tissue destruction requiring intensive wound management, often including surgical debridement. The presence of necrotic tissue indicates failed healing mechanisms and significantly elevated infection risk, including osteomyelitis when bone is involved. This diagnosis reflects high patient complexity and substantial resource needs for risk adjustment purposes.
Documentation Requirements
- ✓Provider documentation of the ulcer as chronic (present for extended duration, not acute)
- ✓Anatomical location clearly specified as buttock
- ✓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
- ✓Imaging studies (X-ray, MRI, or CT) confirming bone involvement with necrosis
- ✓Clinical or pathological evidence of osteonecrosis
- ✓Wound measurements (length, width, depth) and assessment of wound edges and surrounding tissue
- ✓Current treatment plan including wound care interventions
Commonly Confused Codes
L89.3xx — Pressure ulcer of buttock; use when ulcer is caused by sustained pressure, not for non-pressure etiologiesL98.42x — Non-pressure chronic ulcer of back; differs by anatomical location (back vs. buttock)L98.49x — Non-pressure chronic ulcer of other sites; use only when location does not match buttock, back, or specified sitesL97.x — Non-pressure chronic ulcer of lower leg; different anatomical site entirelyL98.416 — Same site with bone involvement WITHOUT necrosis; critical distinction is whether bone tissue is necrotic or viable
Code Hierarchy
└L98Other disorders of skin and subcutaneous tissue, not elsewhere classified└L98.4Non-pressure chronic ulcer of skin, not elsewhere classified└L98.41Non-pressure chronic ulcer of buttock└L98.414Non-pressure chronic ulcer of buttock with necrosis of bone
└L98.414Non-pressure chronic ulcer of buttock with necrosis of bone