Treatment of Ulcers and Symptomatic Hyperkeratoses LCD - R11

This Local Coverage Determination (LCD) has been revised under contractor numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Medicare Coverage Database (MCD) Number: L34199
LCD Title: Treatment of Ulcers and Symptomatic Hyperkeratoses
Effective Date: October 1, 2019
Summary of Changes: This LCD has been updated to include added and new/revised ICD-10 codes per the 2019 ICD-10 annual update.

  • Added/Revised to Group 1:
    • L89.016 - Pressure-induced deep tissue damage of right elbow
    • L89.026 - Pressure-induced deep tissue damage of left elbow
    • L89.116 - Pressure-induced deep tissue damage of right upper back
    • L89.126 - Pressure-induced deep tissue damage of left upper back
    • L89.136 - Pressure-induced deep tissue damage of right lower back
    • L89.146 - Pressure-induced deep tissue damage of left lower back
    • L89.156 - Pressure-induced deep tissue damage of sacral region
    • L89.216 - Pressure-induced deep tissue damage of right hip
    • L89.226 - Pressure-induced deep tissue damage of left hip
    • L89.316 - Pressure-induced deep tissue damage of right buttock
    • L89.326 - Pressure-induced deep tissue damage of left buttock
    • L89.46 - Pressure-induced deep tissue damage of contiguous site of back, buttock and hip
    • L89.516 - Pressure-induced deep tissue damage of right ankle
    • L89.526 - Pressure-induced deep tissue damage of left ankle
    • L89.616 - Pressure-induced deep tissue damage of right heel
    • L89.626 - Pressure-induced deep tissue damage of left heel
    • L89.816 - Pressure-induced deep tissue damage of head
    • L89.896 - Pressure-induced deep tissue damage of other site
    • Revised I70.238 - Atherosclerosis of native arteries of right leg with ulceration of other part of lower right leg to I70.238 - Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
    • Revised I70.248 - Atherosclerosis of native arteries of left leg with ulceration of other part of lower left leg to I70.248 - Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg.

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Last Updated Oct 11, 2019