L98.A215 ICD-10-CM Code: Non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis

L98.A215 is the ICD-10-CM diagnosis code for non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis. A long-lasting open sore on the right forearm that is not caused by pressure, with muscle tissue involved but no dead tissue present. L98.A215 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.A215 maps to Chronic Ulcer of Skin, Except Pressure (HCC 380) with a community, non-dual, aged base RAF weight of 0.426. L98.A215 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.

Verify documentation specifies 'right forearm' and confirms muscle involvement without necrosis. Because L98.A215 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.