L98.495
BillableNon-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis
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 extends into the muscle layer but the muscle tissue is still viable and not dead.
Coding Tips
- •Distinguish this from L98.493 by confirming muscle is involved but NOT necrotic
- •Document the depth and extent of muscle involvement in clinical notes
Clinical Significance
Non-pressure chronic ulcers of the other sites with deep tissue involvement (without necrosis) indicate significant wound depth requiring specialized wound care and monitoring. While the tissue remains viable, the depth of involvement signals ongoing risk for progression to necrosis and potential complications. Accurate coding of the tissue involvement level is essential for appropriate risk adjustment and care planning.
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 of muscle layer exposure or involvement without evidence of necrosis
- ✓Statement confirming muscle tissue is viable (not necrotic)
- ✓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 siteL98.493 — Same site with necrosis of muscle; use when muscle tissue is dead/necrotic, not merely involved
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└L98.495Non-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis
└L98.495Non-pressure chronic ulcer of skin of other sites with muscle involvement without evidence of necrosis