L97.426 Non-pressure chronic ulcer of left heel and midfoot with bone involvement without evidence of necrosis

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from L97 Non-pressure chronic ulcer of lower limb, not elsewhere classified

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

Excludes2 (not included here)

• pressure ulcer (pressure area) (L89.-)
• skin infections (L00-L08)
• specific infections classified to A00-B99

Code 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-)

Applies from L97.4 Non-pressure chronic ulcer of heel and midfoot

Applicable to

• Non-pressure chronic ulcer of plantar surface of midfoot

Risk adjustment (HCC)

• CMS-HCC V28: HCC 380 — Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle
• CMS-HCC V22: HCC 161 — Chronic Ulcer of Skin, Except Pressure
• RxHCC V08: HCC 311 — Chronic Ulcer of Skin, Except Pressure
• ESRD V24: HCC 161

MS-DRG index

Defines the logic of DRG(s) 573-575 in MDC 09.

Approximate ICD-9-CM (GEMs)

• 707.14 Ulcer of heel and midfoot (approximate)

Code annotations containing back-references to L97.426

Back-references to L97.4

• Use Additional: E08.621 Diabetes mellitus due to underlying condition with foot ulcer ("code to identify site of ulcer (L97.4-, L97.5-)")
• Use Additional: E08.622 Diabetes mellitus due to underlying condition with other skin ulcer ("code to identify site of ulcer (L97.1-L97.9, L98.41-L98.49)")
• Use Additional: E09.621 Drug or chemical induced diabetes mellitus with foot ulcer ("code to identify site of ulcer (L97.4-, L97.5-)")
• Use Additional: E09.622 Drug or chemical induced diabetes mellitus with other skin ulcer ("code to identify site of ulcer (L97.1-L97.9, L98.41-L98.49)")
• Use Additional: E10.621 Type 1 diabetes mellitus with foot ulcer ("code to identify site of ulcer (L97.4-, L97.5-)")
• Use Additional: E10.622 Type 1 diabetes mellitus with other skin ulcer ("code to identify site of ulcer (L97.1-L97.9, L98.41-L98.49)")
• Use Additional: E11.621 Type 2 diabetes mellitus with foot ulcer ("code to identify site of ulcer (L97.4-, L97.5-)")
• Use Additional: E11.622 Type 2 diabetes mellitus with other skin ulcer ("code to identify site of ulcer (L97.1-L97.9, L98.41-L98.49)")
• Use Additional: E13.621 Other specified diabetes mellitus with foot ulcer ("code to identify site of ulcer (L97.4-, L97.5-)")
• Use Additional: E13.622 Other specified diabetes mellitus with other skin ulcer ("code to identify site of ulcer (L97.1-L97.9, L98.41-L98.49)")

Back-references to L97

• Use Additional: I70.23 Atherosclerosis of native arteries of right leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.24 Atherosclerosis of native arteries of left leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.26 Atherosclerosis of native arteries of extremities with gangrene ("code to identify the severity of any ulcer (L97.-, L98.49-), if applicable")
• Use Additional: I70.33 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.34 Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.36 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene ("code to identify the severity of any ulcer (L97.-, L98.49-), if applicable")
• Use Additional: I70.43 Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.44 Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.46 Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene ("code to identify the severity of any ulcer (L97.-, L98.49-), if applicable")
• Use Additional: I70.53 Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.54 Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.56 Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene ("code to identify the severity of any ulcer (L97.-, L98.49-), if applicable")
• Use Additional: I70.63 Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.64 Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.66 Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene ("code to identify the severity of any ulcer (L97.-, L98.49-), if applicable")
• Use Additional: I70.73 Atherosclerosis of other type of bypass graft(s) of the right leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.74 Atherosclerosis of other type of bypass graft(s) of the left leg with ulceration ("code to identify severity of ulcer (L97.-)")
• Use Additional: I70.76 Atherosclerosis of other type of bypass graft(s) of the extremities with gangrene ("code to identify the severity of any ulcer (L97.-, L98.49-), if applicable")
• Use Additional: I83.0 Varicose veins of lower extremities with ulcer ("code to identify severity of ulcer (L97.-)")
• Use Additional: I83.2 Varicose veins of lower extremities with both ulcer and inflammation ("code to identify severity of ulcer (L97.-)")
• Use Additional: I87.01 Postthrombotic syndrome with ulcer ("code to specify site and severity of ulcer (L97.-)")
• Use Additional: I87.03 Postthrombotic syndrome with ulcer and inflammation ("code to specify site and severity of ulcer (L97.-)")
• Use Additional: I87.2 Venous insufficiency (chronic) (peripheral) ("code, if applicable, to specify site and severity of ulcer (L97.-)")
• Use Additional: I87.31 Chronic venous hypertension (idiopathic) with ulcer ("code to specify site and severity of ulcer (L97.-)")
• Use Additional: I87.33 Chronic venous hypertension (idiopathic) with ulcer and inflammation ("code to specify site and severity of ulcer (L97.-)")
• Type 2 Excludes: L89 Pressure ulcer ("non-pressure chronic ulcer of skin (L97.-)")
• Type 2 Excludes: L98.4 Non-pressure chronic ulcer of skin, not elsewhere classified ("ulcer of lower limb NEC (L97.-)")
• Type 2 Excludes: L98.A Non-pressure chronic ulcer of upper limb, not elsewhere classified ("ulcer of lower limb NEC (L97.-)")
• Use Additional: T65.84 Toxic effect of xylazine ("non-pressure chronic ulcer of lower limb, not elsewhere classified (L97.-)")

Diagnosis Index entries for L97.426

• Ulcer, ulcerated, ulcerating, ulceration, ulcerative › lower limb (atrophic) (chronic) (neurogenic) (perforating) (pyogenic) (trophic) (tropical) › heel › left › with › bone involvement without evidence of necrosis
• Ulcer, ulcerated, ulcerating, ulceration, ulcerative › lower limb (atrophic) (chronic) (neurogenic) (perforating) (pyogenic) (trophic) (tropical) › midfoot › left › with › bone involvement without evidence of necrosis

Nearby codes

• L97.421 Non-pressure chronic ulcer of left heel and midfoot limited to breakdown of skin
• L97.422 Non-pressure chronic ulcer of left heel and midfoot with fat layer exposed
• L97.423 Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle
• L97.424 Non-pressure chronic ulcer of left heel and midfoot with necrosis of bone
• L97.425 Non-pressure chronic ulcer of left heel and midfoot with muscle involvement without evidence of necrosis
• L97.426 Non-pressure chronic ulcer of left heel and midfoot with bone involvement without evidence of necrosis (this code)
• L97.428 Non-pressure chronic ulcer of left heel and midfoot with other specified severity
• L97.429 Non-pressure chronic ulcer of left heel and midfoot with unspecified severity
• L97.5 Non-pressure chronic ulcer of other part of foot
• L97.50 Non-pressure chronic ulcer of other part of unspecified foot
• L97.501 Non-pressure chronic ulcer of other part of unspecified foot limited to breakdown of skin