L98.A294 — Non-pressure chronic ulcer of unspecified forearm with necrosis of bone

BillableUnspecifiedCC

Is L98.A294 billable?

Yes, but L98.A294 will trip a Medicare edit. L98.A294 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists L98.A294 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.

More specific alternatives

L98.A294 at a glance

Code	L98.A294
Description	Non-pressure chronic ulcer of unspecified forearm with necrosis of bone
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to L98.A294?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name L98.A294 directly.

Unspecified — a laterality-specific code exists — MCE edit 20

A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.

Which MS-DRGs does L98.A294 group to?

L98.A294 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.A294 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is L98.A294 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to L98.A294. They show the wording a clinician may have documented, which often differs from the Tabular description.

Ulcer, ulcerated, ulcerating, ulceration, ulcerative › forearm › with › bone necrosis

Excludes2 — not included here — inherited from Chapter 12

The conditions below are not part of L98.A294, but a patient may have both at the same time. When documentation supports it, L98.A294 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.A