L98.419

Billable

Non-pressure chronic ulcer of buttock 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 long-lasting open sore on the buttock that is not caused by pressure, with severity that is not specified or documented.

Coding Tips

•Query the provider if severity details are available in clinical documentation to assign a more specific code (L98.411-L98.418)
•Ensure this code is not used for pressure ulcers; those require codes from L89 category

Clinical Significance

Non-pressure chronic ulcers of the buttock 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 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
✓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

L89.3xx — Pressure ulcer of buttock; use when ulcer is caused by sustained pressure, not for non-pressure etiologies L98.42x — 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 sites L97.x — Non-pressure chronic ulcer of lower leg; different anatomical site entirely

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 └L98.419Non-pressure chronic ulcer of buttock with unspecified severity

└L98.419Non-pressure chronic ulcer of buttock with unspecified severity