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L97.326 ICD-10-CM Code: Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
6 inclusion terms · 3 Excludes2 · 8 code-first instructions
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 161 · RxHCC V08 category 311

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 573 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC (MDC 09)
  • MS-DRG 574 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC (MDC 09)
  • MS-DRG 575 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC (MDC 09)
  • MS-DRG 592 — SKIN ULCERS WITH MCC (MDC 09)
  • MS-DRG 593 — SKIN ULCERS WITH CC (MDC 09)
  • MS-DRG 594 — SKIN ULCERS WITHOUT CC/MCC (MDC 09)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 380 — Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle (supersedes HCC 381, HCC 382, HCC 383)

Other models: CMS-HCC V22 HCC 161 · RxHCC V08 HCC 311

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for L97.326 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on L97.326 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • 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

Source: inherited from L97

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from L97

Code First

Underlying conditions that must be sequenced before this code.

Source: inherited from L97

Coder workflow for L97.326

MedCoder structured workflow — derived from this code’s own official record

Before you code L97.326

  1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: left). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

Choose the right path

  1. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then L97.326.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewI96, I70.23, I70.24, I70.33, I70.34, I70.43

  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

Consider L97.326. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes2 — not part of L97.326(3 notes)

    Coding workflow: The conditions named in this note are not included in L97.326. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareL89

    See the official tabular notes · Guidelines I.A.12.b

  • Code First — sequencing check(8 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before L97.326. Do not add an underlying condition the record does not document.

    ReviewI96, I70.23, I70.24, I70.33, I70.34, I70.43

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewI96, I70.23, I70.24, I70.33, I70.34, I70.43

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis is a billable ICD-10-CM diagnosis code (L97.326).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  2. Sequencing: 8 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  3. 3 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name L97.326 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 3 Excludes2 notes: L89 — Pressure ulcer (via L97.-), L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified (via L97.-), L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified (via L97.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 31 Use Additional Code instructions across 3 chapters: E08.622 — Diabetes mellitus due to underlying condition with other skin ulcer (via L97.-), E09.622 — Drug or chemical induced diabetes mellitus with other skin ulcer (via L97.-), E10.622 — Type 1 diabetes mellitus with other skin ulcer (via L97.-), E11.622 — Type 2 diabetes mellitus with other skin ulcer (via L97.-), E13.622 — Other specified diabetes mellitus with other skin ulcer (via L97.-), I70.23 — Atherosclerosis of native arteries of right leg with ulceration (via L97.-), I70.24 — Atherosclerosis of native arteries of left leg with ulceration (via L97.-), I70.26 — Atherosclerosis of native arteries of extremities with gangrene (via L97.-), I70.33 — Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration (via L97.-), I70.34 — Atherosclerosis of unspecified type of bypass graft(s) of the left leg with ulceration (via L97.-), I70.36 — Atherosclerosis of unspecified type of bypass graft(s) of the extremities with gangrene (via L97.-), I70.43 — Atherosclerosis of autologous vein bypass graft(s) of the right leg with ulceration (via L97.-), I70.44 — Atherosclerosis of autologous vein bypass graft(s) of the left leg with ulceration (via L97.-), I70.46 — Atherosclerosis of autologous vein bypass graft(s) of the extremities with gangrene (via L97.-), I70.53 — Atherosclerosis of nonautologous biological bypass graft(s) of the right leg with ulceration (via L97.-), I70.54 — Atherosclerosis of nonautologous biological bypass graft(s) of the left leg with ulceration (via L97.-), I70.56 — Atherosclerosis of nonautologous biological bypass graft(s) of the extremities with gangrene (via L97.-), I70.63 — Atherosclerosis of nonbiological bypass graft(s) of the right leg with ulceration (via L97.-), I70.64 — Atherosclerosis of nonbiological bypass graft(s) of the left leg with ulceration (via L97.-), I70.66 — Atherosclerosis of nonbiological bypass graft(s) of the extremities with gangrene (via L97.-), +11 more.

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 325 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 6 MS-DRGs: DRG 573 (MDC 09), DRG 574 (MDC 09), DRG 575 (MDC 09), DRG 592 (MDC 09), DRG 593 (MDC 09), DRG 594 (MDC 09).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SKN004 — Non-pressure ulcer of skin (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

L97.306 — Non-pressure chronic ulcer of unspecified ankle with bone involvement without evidence of necrosis (unspecified)Compare L97.326 vs L97.306 →, L97.316 — Non-pressure chronic ulcer of right ankle with bone involvement without evidence of necrosis (right)Compare L97.326 vs L97.316 →

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) for risk-adjusted payment.

L97.304 — Non-pressure chronic ulcer of unspecified ankle with necrosis of bone, L97.305 — Non-pressure chronic ulcer of unspecified ankle with muscle involvement without evidence of necrosis, L97.306 — Non-pressure chronic ulcer of unspecified ankle with bone involvement without evidence of necrosis, L97.313 — Non-pressure chronic ulcer of right ankle with necrosis of muscle, L97.314 — Non-pressure chronic ulcer of right ankle with necrosis of bone, L97.315 — Non-pressure chronic ulcer of right ankle with muscle involvement without evidence of necrosis, L97.316 — Non-pressure chronic ulcer of right ankle with bone involvement without evidence of necrosis, L97.323 — Non-pressure chronic ulcer of left ankle with necrosis of muscle, L97.324 — Non-pressure chronic ulcer of left ankle with necrosis of bone, L97.325 — Non-pressure chronic ulcer of left ankle with muscle involvement without evidence of necrosis, L97.403 — Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of muscle, L97.404 — Non-pressure chronic ulcer of unspecified heel and midfoot with necrosis of bone, L97.405 — Non-pressure chronic ulcer of unspecified heel and midfoot with muscle involvement without evidence of necrosis, L97.406 — Non-pressure chronic ulcer of unspecified heel and midfoot with bone involvement without evidence of necrosis, L97.413 — Non-pressure chronic ulcer of right heel and midfoot with necrosis of muscle, L97.414 — Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone, L97.415 — Non-pressure chronic ulcer of right heel and midfoot with muscle involvement without evidence of necrosis, L97.416 — Non-pressure chronic ulcer of right heel and midfoot with bone involvement without evidence of necrosis, 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, +131 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone, Pressure Ulcer of Skin with Full Thickness Skin Loss, Pressure Ulcer of Skin with Partial Thickness Skin Loss, Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Non-pressure ulcer of skin).

+303 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HbA1c Test (Glycated Hemoglobin), Blood Glucose Test

Contextual Map

Every relationship of L97.326 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run L97.326 with these 11 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions (31)

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 380 — Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle [CMS-HCC]: “Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle — supersedes HCC 381 (Pressure Ulcer of Skin with Full Thickness Skin Loss), HCC 382 (Pressure Ulcer of Skin with Partial Thickness Skin Loss), HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle)”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 09 — Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast[MDC crossing]: “Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 7,376 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Ulcer, ulcerated, ulcerating, ulceration, ulcerative, lower limb (atrophic) (chronic) (neurogenic) (perforating) (pyogenic) (trophic) (tropical), ankle, left, with, bone involvement without evidence of necrosis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

Change history

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "L97.326 — Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/l97.326-non-pressure-chronic-ulcer-of-left-ankle-with-bone-involvement-without-evidence-of-necrosis

Change history

  • FY2018 — October 1, 2017
    Added to the code set
    Non-pressure chronic ulcer of left ankle with bone involvement without evidence of necrosis
    FY2018 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to L97.326 in its code family, with their registry titles.

View all codes in the L97 family