L98.491

Billable

Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin

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 other areas of the body (not face or groin) that is not caused by pressure, affecting only the outer layer of skin.

Coding Tips

•Specify the exact anatomical location in documentation to support medical necessity
•This is the least severe stage of non-pressure ulcer on other body sites

Clinical Significance

Non-pressure chronic ulcers of the other sites indicate ongoing tissue breakdown from non-pressure etiologies such as venous insufficiency, arterial disease, or inflammatory conditions. This code captures a superficial severity level (limited to breakdown of skin), which still reflects significant wound care needs and underlying vascular or systemic disease. Accurate capture is critical for risk adjustment as it reflects patient complexity and anticipated resource utilization.

Documentation Requirements

✓Provider documentation of the ulcer as chronic (present for extended duration, not acute)
✓Anatomical location clearly specified as other sites
✓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
✓Documentation that ulcer is limited to skin breakdown only (epidermis/dermis involvement)
✓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; must differentiate by etiology (pressure vs. non-pressure)L98.41x — Non-pressure chronic ulcer of buttock; use when buttock is the documented site L98.42x — Non-pressure chronic ulcer of back; use when back is the documented site L97.x — Non-pressure chronic ulcer of lower leg; use when lower extremity is the documented site

Code Hierarchy

└L98Other disorders of skin and subcutaneous tissue, not elsewhere classified └L98.4Non-pressure chronic ulcer of skin, not elsewhere classified └L98.49Non-pressure chronic ulcer of skin of other sites └L98.491Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin

└L98.491Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin