What is ICD-10 code L98.A221?

L98.A221 is the ICD-10-CM diagnosis code for Non-pressure chronic ulcer of left forearm limited to breakdown of skin. A long-lasting open sore on the left forearm that is not caused by pressure, affecting only the outer layer of skin. L98.A221 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L98.A221 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Is L98.A221 billable?

Yes. L98.A221 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. L98.A221 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for L98.A221?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. L98.A221 is a payment HCC under V28 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle) but was not retained as a payment HCC under V24. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting L98.A221?

Confirm laterality is left forearm and ulcer is limited to skin breakdown only This represents the least severe category of non-pressure ulcer Because L98.A221 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM L98.A221: Non-pressure chronic

ICD-10-CM Code View

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Code lookupL98.A221Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)

L98.A221

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Non-pressure chronic ulcer of left forearm limited to breakdown of skin

A long-lasting open sore on the left forearm that is not caused by pressure, affecting only the outer layer of skin.

CMS-HCC V28

Mapped

HCC 383

Chronic Ulcer of Skin, Except...

RAF 0.646

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

Mapped

HCC 217

HHS-HCC 217

Varies by metal level

ESRD/PACE

Mapped

HCC 161

Chronic Ulcer of Skin, Except...

RAF 0.127

RXHCC

Mapped

HCC 311

Diabetic and Chronic Skin Ulcer

RAF 0.175

Code Book Path

Official

L98.A2Non-pressure chronic ulcer of forearm

L98.A22Non-pressure chronic ulcer of left forearm

L98.A221Non-pressure chronic ulcer of left forearm limited to breakdown of skin

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L98.A221 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L98.A221 in this effective period.

Related Child Codes

Official

L98.A222Non-pressure chronic ulcer of left forearm with fat layer exposed

L98.A223Non-pressure chronic ulcer of left forearm with necrosis of muscle

L98.A224Non-pressure chronic ulcer of left forearm with necrosis of bone

L98.A225Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis

L98.A226Non-pressure chronic ulcer of left forearm with bone involvement without evidence of necrosis

Includes

Official

ICD-10-CM does not list Includes notes for L98.A221 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L98.A221 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L98.A221 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L98.A221 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L98.A221 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Confirm laterality is left forearm and ulcer is limited to skin breakdown only

This represents the least severe category of non-pressure ulcer

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is L98.A221 an HCC code?

Yes. L98.A221 (Non-pressure chronic ulcer of left forearm limited to breakdown of skin) maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle under the CMS-HCC V28 risk adjustment model, with a community non-dual aged RAF of 0.646. It is billable for payment year 2026.

Coder answer: L98.A221 is billable and maps to V28 HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: L98.A221
Description: Non-pressure chronic ulcer of left forearm limited to breakdown of skin
HCC (V28): HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle
RAF: 0.646
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 383, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

0.646

ESRDHCC 161, Chronic Ulcer of Skin, Except Pressure

0.127

RxHCCHCC 311, Diabetic and Chronic Skin Ulcer

0.175

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work L98.A221 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for L98.A221

For L98.A221 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed L98.A221 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

L98.A221 is the ICD-10-CM diagnosis code for non-pressure chronic ulcer of left forearm limited to breakdown of skin. A long-lasting open sore on the left forearm that is not caused by pressure, affecting only the outer layer of skin. L98.A221 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.A221 maps to Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle (HCC 383) with a community, non-dual, aged base RAF weight of 0.646. L98.A221 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.

Confirm laterality is left forearm and ulcer is limited to skin breakdown only. Because L98.A221 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.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L98.A221 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.