Date Posted: March 5, 2026

This Billing and Coding Article has been revised under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: October 1, 2025

Summary of Changes:

Under ICD-10-CM Codes that Support Medical Necessity, Group 1: Codes, added: L98.431*, L98.432*, L98.471*, L98.472*, L98.473*, L98.A111*, L98.A112*, L98.A113*, L98.A114*, L98.A115*, L98.A116*, L98.A118*, L98.A121*, L98.A122*, L98.A123*, L98.A124*, L98.A125*, L98.A126*, L98.A128*, L98.A221*, L98.A222*, L98.A223*, L98.A224*, L98.A225*, L98.A226*, L98.A228*, S30.85AA, S30.85AD, S30.85AS, S31.116A, S31.116D, S31.116S, S31.117A, S31.117D, S31.117S, S31.11AA, S31.11AD, S31.11AS, S31.126A, S31.126D, S31.126S, S31.127A, S31.127D, S31.127S, S31.12AA, S31.12AD, S31.12AS

Under ICD-10-CM Codes that Support Medical Necessity, Group 1: Codes, Group 1: Medical Necessity ICD-10-CM Codes Asterisk Explanation, revised sentence from "For clarity one should consider adding a 2nd ICD-10 code (L97.1XX - L98.4XX ICD-10 codes asterisked above) to define the ulcer." to "For clarity one should consider adding a 2nd ICD-10 code (L97.1XX - L98.AXXX ICD-10 codes asterisked above) to define the ulcer."

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