ICD-10 L98.A211
Billable / Specific HCC v28: 161Non-pressure chronic ulcer of right forearm limited to breakdown of skin
About ICD-10-CM L98.A211
ICD-10-CM code L98.A211 represents Non-pressure chronic ulcer of right forearm limited to breakdown of skin. This is a billable/specific code in the Skin and Subcutaneous Tissue chapter (block L98). The 2026 edition of ICD-10-CM L98.A211 became effective on October 1, 2025.
Coding Tips for L98.A211
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
L98.A211 is a CMS-HCC v28 risk-adjustment code (category 161). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for L98.A211
Local Coverage Determinations (LCDs) from CMS MACs that list L98.A211 as a covered diagnosis.
Showing top 10 of 332 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing L98.A211.
5 Medicare
CPT Codes Commonly Billed with L98.A211
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To L98.A211
Other codes in section L80-L99 (Other disorders of the skin and subcutaneous tissue).
ICD-10 L98.A211, Billing FAQ
Is ICD-10 code L98.A211 billable? +
Yes, L98.A211 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does L98.A211 affect Medicare Advantage HCC risk adjustment? +
Yes. L98.A211 maps to CMS-HCC v28 category 161. Capture this diagnosis annually for accurate Medicare Advantage risk score.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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