Coding and coverage · ICD-10-CM
L97.415 Non-pressure chronic ulcer of right heel and midfoot with muscle involvement without evidence of necrosis
Instructional notes
Chapter 12
Excludes2Not included here: the patient may have both; report both when both are present.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- lipomelanotic reticulosis (I89.8)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- viral warts (B07.-)
L97
Excludes2Not included here: the patient may have both; report both when both are present.
Code firstSequence the underlying condition first.
- any associated underlying condition, such as:
- any associated gangrene (I96)
- atherosclerosis of the lower extremities (I70.23-, I70.24-, I70.33-, I70.34-, I70.43-, I70.44-, I70.53-, I70.54-, I70.63-, I70.64-, I70.73-, I70.74-)
- chronic venous hypertension (I87.31-, I87.33-)
- diabetic ulcers (E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621, E13.622)
- postphlebitic syndrome (I87.01-, I87.03-)
- postthrombotic syndrome (I87.01-, I87.03-)
- varicose ulcer (I83.0-, I83.2-)
Includes
- chronic ulcer of skin of lower limb NOS
- non-healing ulcer of skin
- non-infected sinus of skin
- trophic ulcer NOS
- tropical ulcer NOS
- ulcer of skin of lower limb NOS
L97.4
Inclusion terms
- Non-pressure chronic ulcer of plantar surface of midfoot
Chapter 12: Diseases of the skin and subcutaneous tissue · L80-L99 Other disorders of the skin and subcutaneous tissue (L80-L99)
Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.
Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.