Wound and Ulcer Coding: Pressure, Diabetic, and Debridement

Code sets: FY 2027 ICD-10-CM; CY 2026 CPT.

Wound or ulcer?

In ICD-10-CM language, a wound is traumatic and is coded to Chapter 19 (S codes). An ulcer is a break in the skin that fails to heal, and is coded by type: pressure (L89.-), non-pressure chronic (L97.- for the lower limb, L98.4- for other sites), diabetic, or venous.

Pressure ulcers (L89)

• Codes combine site, laterality, and stage: stage 1-4, unstageable (L89.–0), unspecified stage (L89.–9), and pressure-induced deep tissue damage (L89.–6).
• Unstageable means the stage cannot be determined (for example, covered by eschar). Unspecified means no stage was documented. Do not mix them up (FY 2027 ICD-10-CM Guidelines, Section I.C.12.a).
• If debridement during the encounter reveals the stage of an unstageable ulcer, assign only the code for the stage revealed after debridement (Section I.C.12.a.2).
• A healing pressure ulcer is coded at its documented stage.

Diabetic and non-pressure ulcers

• A diabetic foot ulcer takes two codes: E11.621 Type 2 diabetes mellitus with foot ulcer, plus an L97.4- or L97.5- code for site and severity, as the “use additional code” note at E11.621 instructs.
• L97 codes describe severity: limited to breakdown of skin, fat layer exposed, necrosis of muscle, necrosis of bone, and others. Example: L97.412 Non-pressure chronic ulcer of right heel and midfoot with fat layer exposed.
• The diabetic and pressure ulcer categories exclude each other, so code what the provider documents.

Debridement (CPT)

• 11042-11047 (surgical debridement) are chosen by the deepest level of tissue removed: subcutaneous tissue (11042, +11045), muscle and/or fascia (11043, +11046), or bone (11044, +11047). The base code covers the first 20 sq cm; the add-on codes each additional 20 sq cm.
• 97597-97598 (selective debridement, active wound care) cover removal of devitalized tissue without anesthesia, by surface area.
• When several wounds are debrided to the same depth, add their surface areas together. Wounds at different depths are reported separately.

Documentation to look for

• Ulcer type, site, laterality, and stage or severity.
• Size (length x width) before and after debridement.
• The deepest tissue layer removed and the instrument used.

Refreshed from the CCO Community archive, November 2026.