L98.428 — Non-pressure chronic ulcer of back with other specified severity
Is L98.428 billable?
Yes, but L98.428 is an unspecified code. L98.428 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, L98.428 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting L98.428 — the more specific alternatives are listed below.
More specific alternatives
- L98.421Non-pressure chronic ulcer of back limited to breakdown of skin
- L98.422Non-pressure chronic ulcer of back with fat layer exposed
- L98.423Non-pressure chronic ulcer of back with necrosis of muscle
- L98.424Non-pressure chronic ulcer of back with necrosis of bone
- L98.425Non-pressure chronic ulcer of back with muscle involvement without evidence of necrosis
- L98.426Non-pressure chronic ulcer of back with bone involvement without evidence of necrosis
L98.428 at a glance
| Code | L98.428 |
|---|---|
| Description | Non-pressure chronic ulcer of back with other specified severity |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does L98.428 group to?
L98.428 sits in MDC 09 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 573Skin Graft for Skin Ulcer or Cellulitis with MCCsurgical
- 574Skin Graft for Skin Ulcer or Cellulitis with CCsurgical
- 575Skin Graft for Skin Ulcer or Cellulitis without CC/MCCsurgical
As a secondary diagnosis, L98.428 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is L98.428 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to L98.428. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Ulcer, ulcerated, ulcerating, ulceration, ulcerative › back › with › specified severity NEC
Excludes2 — not included here — inherited from Chapter 12
The conditions below are not part of L98.428, but a patient may have both at the same time. When documentation supports it, L98.428 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- lipomelanotic reticulosis (I89.8)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- viral warts (B07.-)
Excludes2 — not included here — inherited from L98.4
The conditions below are not part of L98.428, but a patient may have both at the same time. When documentation supports it, L98.428 and the excluded code may both be reported.
How long has L98.428 existed?
L98.428 first appears in FY2018 (FY2017 is not available, so it may have appeared then).
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the L98.42 family? (7)
- L98.421Non-pressure chronic ulcer of back limited to breakdown of skin
- L98.422Non-pressure chronic ulcer of back with fat layer exposed
- L98.423Non-pressure chronic ulcer of back with necrosis of muscle
- L98.424Non-pressure chronic ulcer of back with necrosis of bone
- L98.425Non-pressure chronic ulcer of back with muscle involvement without evidence of necrosis
- L98.426Non-pressure chronic ulcer of back with bone involvement without evidence of necrosis
- L98.429Non-pressure chronic ulcer of back with unspecified severity