L98.A212 ICD-10-CM Code: Non-pressure chronic ulcer of right forearm with fat layer exposed

L98.A212 is the ICD-10-CM diagnosis code for non-pressure chronic ulcer of right forearm with fat layer exposed. A long-lasting open wound on the right forearm that is not caused by pressure, with the fatty tissue layer exposed. L98.A212 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.A212 maps to Diabetic Skin Ulcer and Severe Skin Conditions (HCC 383) with a community, non-dual, aged base RAF weight of 0.517. L98.A212 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 that the ulcer extends through skin into subcutaneous fat layer. Because L98.A212 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.