L98.A225 ICD-10-CM Code: Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis

L98.A225 is the ICD-10-CM diagnosis code for non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis. A long-lasting open sore on the left forearm that is not caused by pressure, with muscle tissue involved but no dead tissue present. L98.A225 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.A225 maps to Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle (HCC 380) with a source-labeled community, non-dual, aged reference coefficient of 1.078. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Distinguish from L98.A223 which indicates muscle necrosis is present. For L98.A225, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.