2021 ICD-10-CM Code L97.406
Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis
Valid for Submission
| ICD-10: | L97.406 |
| Short Description: | Non-prs chr ulc unsp heel/midft w bne invl w/o evd of necr |
| Long Description: | Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis |
Code Classification
L97.406 is a billable diagnosis code used to specify a medical diagnosis of non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis. The code L97.406 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
Unspecified diagnosis codes like L97.406 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code L97.406 are found in the index:
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code L97.406 is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2021.
| MS-DRG | MS-DRG Title | MCD | Relative Weight |
|---|---|---|---|
| 573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC | 09 | 5.5373 |
| 574 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC | 09 | 3.2465 |
| 575 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | 09 | 1.7615 |
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Replacement Code
L97406 replaces the following previously assigned ICD-10 code(s):
- L97.409 - Non-prs chronic ulcer of unsp heel and midfoot w unsp severt
Convert L97.406 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code L97.406 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
- 707.14 - Ulcer of heel & midfoot (Approximate Flag)
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018