L98.499
BillableNon-pressure chronic ulcer of skin of other sites with unspecified severity
HCC Category Mapping
V28HCC 383 — Diabetic Skin Ulcer and Severe Skin Conditions
0.517V24HCC 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 where the severity level or depth of tissue involvement is not specified or documented.
Coding Tips
- •This is a default code when severity cannot be determined; query the provider for more specific documentation
- •Avoid using this code if any severity indicators are documented in the record
Clinical Significance
Non-pressure chronic ulcers of the other sites 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 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
- ✓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.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 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└L98.499Non-pressure chronic ulcer of skin of other sites with unspecified severity
└L98.499Non-pressure chronic ulcer of skin of other sites with unspecified severity