L98.494
BillableNon-pressure chronic ulcer of skin of other sites 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 non-pressure wound on the skin that has eroded deeply enough to involve bone tissue that has died or deteriorated.
Coding Tips
- •This represents severe ulceration with bone involvement; ensure imaging or clinical documentation supports bone necrosis
- •Coordinate with orthopedic or surgical documentation if bone debridement was performed
Clinical Significance
Non-pressure chronic ulcers of the other sites 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 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
- ✓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.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 siteL98.42x — Non-pressure chronic ulcer of back; use when back is the documented siteL97.x — Non-pressure chronic ulcer of lower leg; use when lower extremity is the documented siteL98.496 — 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└L98.49Non-pressure chronic ulcer of skin of other sites└L98.494Non-pressure chronic ulcer of skin of other sites with necrosis of bone
└L98.494Non-pressure chronic ulcer of skin of other sites with necrosis of bone