L97.812: Non-pressure chronic ulcer of other part of right lower leg with fat layer exposed

L97.812, non-pressure chronic ulcer of other part of right lower leg with fat layer exposed, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including G0281 (Electrical stimulation, (unattended), to one or more…), G0329 (Electromagnetic therapy, to one or more areas for chronic…), G0283 (Electrical stimulation (unattended), to one or more areas…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with L97.812 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of careCarrier judgment—3
G0329Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of careCarrier judgment—3
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careCarrier judgment—3
G0152Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0158Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutesCarrier judgment—1
G0160Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutesCarrier judgment—1
G2169Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutesCarrier judgment—1
G2010Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G2250Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointmentCarrier judgment—1
G2251Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussionCarrier judgment—1
G0151Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutesCarrier judgment—1

Medicare policy articles listing L97.812

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other L97 diagnoses (Non-pressure chronic ulcer of lower limb, not elsewhere classified)

Frequently asked questions

Does Medicare cover L97.812 (Non-pressure chronic ulcer of other part of right lower…)?

Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list L97.812 as a covered diagnosis for 11 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 L97.812?

The Level II codes from the policies most specific to this diagnosis are G0281 (Electrical stimulation, (unattended), to one or more…, 3 articles); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 3 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 3 articles); G0152 (Services performed by a qualified occupational therapist…, 1 article); G0158 (Services performed by a qualified occupational therapist…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list L97.812?

A55909 (Billing and Coding: Wound Care); A53057 (Billing and Coding: Home Health Occupational Therapy); A53064 (Billing and Coding: Outpatient Occupational Therapy), and 1 more article.

What is ICD-10-CM code L97.812?

L97.812 is the ICD-10-CM code for non-pressure chronic ulcer of other part of right lower leg with fat layer exposed, in category L97 (Non-pressure chronic ulcer of lower limb, not elsewhere classified), chapter 12: Diseases of the skin and subcutaneous tissue.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 12: Diseases of the skin and subcutaneous tissue · All diagnoses · HCPCS lookup