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ICD-10 Guide
ICD-10 CodesL89.139

L89.139

Billable

Pressure ulcer of right lower back, unspecified stage

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 L89.139 is a billable code used to indicate a diagnosis of pressure ulcer of right lower back, unspecified stage.

Key Diagnostic Point:

Pressure ulcers, also known as bedsores or decubitus ulcers, are localized injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. The right lower back is a common site for these ulcers due to its anatomical position and the pressure exerted when a patient is in a supine position. Clinically, pressure ulcers can present as intact skin with non-blanchable redness or as open wounds with varying degrees of tissue loss. The disease progression can lead to serious complications, including infections, which may necessitate surgical intervention. Diagnostic considerations for L89.139 include a thorough patient history, physical examination, and assessment of risk factors such as immobility, malnutrition, and moisture. It is essential to evaluate the ulcer's stage, although this code specifies 'unspecified stage,' indicating that the exact stage of the ulcer is not documented or cannot be determined at the time of coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires assessment of ulcer stage and patient risk factors.
  • Treatment complexity: Involves multidisciplinary approaches including wound care, nutrition, and possibly surgical intervention.
  • Documentation requirements: Detailed documentation of ulcer characteristics and patient history is necessary.
  • Coding specificity: While L89.139 is specific to the right lower back, it lacks detail on the ulcer stage.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcer stage or site.
  • Documentation gaps: Incomplete records regarding ulcer assessment and treatment.
  • Billing challenges: Potential denials due to insufficient documentation or unclear coding.

Specialty Focus

Medical Specialties

Primary medical specialty: Dermatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Wound care management

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Pressure ulcers significantly impact patient health, leading to increased morbidity and healthcare costs. They are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Effective management of pressure ulcers is critical for improving quality measures and reducing hospital readmission rates. Epidemiologically, the incidence of pressure ulcers highlights the need for preventive strategies in healthcare settings to enhance patient outcomes and reduce overall healthcare utilization.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient health, leading to increased morbidity and healthcare costs. They are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Effective management of pressure ulcers is critical for improving quality measures and reducing hospital readmission rates. Epidemiologically, the incidence of pressure ulcers highlights the need for preventive strategies in healthcare settings to enhance patient outcomes and reduce overall healthcare utilization.

Reimbursement & Billing Impact

Reimbursement may vary based on the severity and stage of the ulcer, as well as the treatment modalities used. Common denials may occur if documentation does not clearly support the diagnosis or if the treatment plan is not adequately detailed. It is essential to follow coding best practices, ensuring that all relevant information is included in the medical record to support the claim.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by L89.139?

L89.139 covers pressure ulcers located on the right lower back, which may include various stages of ulceration, although the specific stage is not documented. It is important to note that this code does not cover ulcers from other causes, such as venous stasis or diabetic ulcers.

When should L89.139 be used instead of related codes?

L89.139 should be used when documenting a pressure ulcer specifically located on the right lower back without a specified stage. If the stage is known, a more specific code should be selected from the L89 series that corresponds to the stage of the ulcer.

What documentation supports L89.139?

Documentation should include a detailed description of the ulcer's characteristics, including size, depth, and any signs of infection. Additionally, the patient's risk factors, treatment plan, and response to treatment should be clearly documented to support the use of this code.