L98.455 ICD-10-CM Code: Non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis

L98.455 is the ICD-10-CM diagnosis code for non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis. A long-lasting open wound on the neck that is not caused by pressure and involves muscle tissue without dead tissue. L98.455 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering other disorders of the skin and subcutaneous tissue (l80-l99).

Under the CMS-HCC V28 risk adjustment model, L98.455 maps to Chronic Ulcer of Skin, Except Pressure (HCC 380) with a community, non-dual, aged base RAF weight of 0.426. L98.455 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Document muscle involvement while confirming absence of necrosis. Because L98.455 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.