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L98.A313 ICD-10-CM Code: Non-pressure chronic ulcer of right hand with necrosis of muscle

Compare with another codeCheck this code on a claim

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

Coding at a Glance

Tabular directives
6 Excludes2
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 161 · RxHCC V08 category 311

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes2Not included here; may be reported together
  • gangrene (I96)
  • pressure ulcer (pressure area) (L89.-)
  • skin infections (L00-L08)
  • specific infections classified to A00-B99

+2 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

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 v44, 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 L98.A313 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on L98.A313 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

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

Source: inherited from L98.A

7th Character Guide

Variant codes in this family

L98.A311, L98.A312, L98.A313, L98.A314, L98.A315, L98.A316, L98.A318, L98.A319

Character meanings are CMS's official 7th-character extensions for this family, as carried in each variant code's official description; variant codes are registry rows. The explanation of how the encounter character is assigned is MedCoder editorial, distinct from the official content above it.

Coder workflow for L98.A313

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

Before you code L98.A313

  1. A 7th character is required in this family. Confirm the documentation supports the character assigned — its meaning in this family is defined in the official instruction. This page’s code carries “3”. The official 7th-character definitions for this family are quoted in the guide.

    See the 7th Character Guide

  2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). 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).

    ReviewL98.A323 · left, L98.A393 · unspecified

    Guide: Laterality coding →

  3. L98.A313’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

Choose the right path

  1. 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.

    ReviewL98.A323 · left, L98.A393 · unspecified

  2. Does the documentation support one of this family’s 7th-character values?
    Yes → Assign the matching 7th character; the variant codes are in the 7th Character Guide.
    No → The code is invalid without its 7th character — query for the missing element.

Consider L98.A313. 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).
7th-character basis
The documented element this family’s 7th character records (see the official definitions in the 7th Character Guide).
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).

Official instructions as workflow

  • Excludes2 — not part of L98.A313(6 notes)

    Coding workflow: The conditions named in this note are not included in L98.A313. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareI96, L89, L97

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

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).

ReviewL98.A323 · left, L98.A393 · unspecified

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is L98.A313 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

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.

Don’t confuse L98.A313 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of L98.A313 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • L98.A319— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Non-pressure chronic ulcer of right hand with unspecified severity” takes L98.A319; specificity in the record moves it back here.

    Full comparison: L98.A313 vs L98.A319 →

  • L98.A323— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to L98.A323.

    Full comparison: L98.A313 vs L98.A323 →

  • L98.A393— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A record that states no side takes L98.A393; a documented side moves it back to a sided code.

    Full comparison: L98.A313 vs L98.A393 →

  • L98.A311— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    Full comparison: L98.A313 vs L98.A311 →

  • L98.A312— Encounter relationship (Review)

    Same underlying diagnosis, different encounter phase.

    The same diagnosis at a different phase of care; one encounter takes one 7th character.

    Full comparison: L98.A313 vs L98.A312 →

  • I96— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of gangrene adds I96; it is not part of this code and both may be reported when both are documented.

    Full comparison: L98.A313 vs I96 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Non-pressure chronic ulcer of right hand with necrosis of muscle is a billable ICD-10-CM diagnosis code (L98.A313).

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

Decision Points

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

  1. A 7th character applies in this family. Confirm the documented encounter matches the character assigned. See the official 7th-character definitions and this code’s variants
  2. 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
  3. 6 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 (FY2027). 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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name L98.A313 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 5 Use Additional Code instructions: E08.622 — Diabetes mellitus due to underlying condition with other skin ulcer (via L98.-), E09.622 — Drug or chemical induced diabetes mellitus with other skin ulcer (via L98.-), E10.622 — Type 1 diabetes mellitus with other skin ulcer (via L98.-), E11.622 — Type 2 diabetes mellitus with other skin ulcer (via L98.-), E13.622 — Other specified diabetes mellitus with other skin ulcer (via L98.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 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.

L98.A323 — Non-pressure chronic ulcer of left hand with necrosis of muscle (left)Compare L98.A313 vs L98.A323 →, L98.A393 — Non-pressure chronic ulcer of unspecified hand with necrosis of muscle (unspecified)Compare L98.A313 vs L98.A393 →

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.

L98.A215 — Non-pressure chronic ulcer of right forearm with muscle involvement without evidence of necrosis, L98.A216 — Non-pressure chronic ulcer of right forearm with bone involvement without evidence of necrosis, L98.A223 — Non-pressure chronic ulcer of left forearm with necrosis of muscle, L98.A224 — Non-pressure chronic ulcer of left forearm with necrosis of bone, L98.A225 — Non-pressure chronic ulcer of left forearm with muscle involvement without evidence of necrosis, L98.A226 — Non-pressure chronic ulcer of left forearm with bone involvement without evidence of necrosis, L98.A293 — Non-pressure chronic ulcer of unspecified forearm with necrosis of muscle, L98.A294 — Non-pressure chronic ulcer of unspecified forearm with necrosis of bone, L98.A295 — Non-pressure chronic ulcer of unspecified forearm with muscle involvement without evidence of necrosis, L98.A296 — Non-pressure chronic ulcer of unspecified forearm with bone involvement without evidence of necrosis, L98.A314 — Non-pressure chronic ulcer of right hand with necrosis of bone, L98.A315 — Non-pressure chronic ulcer of right hand with muscle involvement without evidence of necrosis, L98.A316 — Non-pressure chronic ulcer of right hand with bone involvement without evidence of necrosis, L98.A323 — Non-pressure chronic ulcer of left hand with necrosis of muscle, L98.A324 — Non-pressure chronic ulcer of left hand with necrosis of bone, L98.A325 — Non-pressure chronic ulcer of left hand with muscle involvement without evidence of necrosis, L98.A326 — Non-pressure chronic ulcer of left hand with bone involvement without evidence of necrosis, L98.A393 — Non-pressure chronic ulcer of unspecified hand with necrosis of muscle, L98.A394 — Non-pressure chronic ulcer of unspecified hand with necrosis of bone, L98.A395 — Non-pressure chronic ulcer of unspecified hand with muscle involvement without evidence of necrosis, +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.

Blood Glucose Test

Contextual Map

Every relationship of L98.A313 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 L98.A313 with these 5 related codes in Claim Check

Hierarchy

Referenced by Use Additional Code instructions

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. 7,378 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Ulcer, ulcerated, ulcerating, ulceration, ulcerative, hand, right, with, muscle necrosis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (40)

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

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.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "L98.A313 — Non-pressure chronic ulcer of right hand with necrosis of muscle." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/l98.a313-non-pressure-chronic-ulcer-of-right-hand-with-necrosis-of-muscle

Change history

  • FY2026 — October 1, 2025
    Added to the code set
    Non-pressure chronic ulcer of right hand with necrosis of muscle
    FY2026 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to L98.A313 in its code family, with their registry titles.

View all codes in the L98 family