L98.455 — Non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis
L98.455 is a billable, specific ICD-10-CM code for non-pressure chronic ulcer of neck with muscle involvement without evidence of necrosis. It is valid for submission on a claim.
Risk adjustment
L98.455 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 380 Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle1.078 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
L98.455 is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
How L98.455 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to L98.455.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative›neck›with›muscle involvement without evidence of necrosis
Related codes at this level
Codes that share L98.45. If L98.455 is not quite right, the correct code is usually one of these.
- L98.451Non-pressure chronic ulcer of neck limited to breakdown of skin
- L98.452Non-pressure chronic ulcer of neck with fat layer exposed
- L98.453Non-pressure chronic ulcer of neck with necrosis of muscle
- L98.454Non-pressure chronic ulcer of neck with necrosis of bone
- L98.456Non-pressure chronic ulcer of neck with bone involvement without evidence of necrosis
- L98.458Non-pressure chronic ulcer of neck with other specified severity
- L98.459Non-pressure chronic ulcer of neck with unspecified severity
Questions about L98.455
- Is L98.455 a billable ICD-10-CM code?
- Yes. L98.455 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L98.455 sit in the tabular list?
- Diseases of the skin and subcutaneous tissue (L00-L99), in the block Other disorders of the skin and subcutaneous tissue (L80-L99).