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ICD-10 Guide
ICD-10 CodesL89.149

L89.149

Billable

Pressure ulcer of left lower back, unspecified stage

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

Code Description

ICD-10 L89.149 is a billable code used to indicate a diagnosis of pressure ulcer of left lower back, unspecified stage.

Key Diagnostic Point:

L89.149 refers to a pressure ulcer located on the left lower back, classified as unspecified stage. Pressure ulcers, also known as bedsores or decubitus ulcers, occur when prolonged pressure on the skin restricts blood flow to the area, leading to tissue damage. The left lower back is a common site for these ulcers, particularly in individuals with limited mobility or those who are bedridden. Clinically, the presentation may vary from intact skin with non-blanchable redness to full-thickness tissue loss. The disease progression can lead to severe complications, including infections, if not properly managed. Diagnostic considerations include a thorough patient history, physical examination, and assessment of risk factors such as immobility, nutritional status, and comorbid conditions. Accurate staging of pressure ulcers is crucial for treatment planning and monitoring, although this code does not specify the stage of the ulcer, indicating a need for further evaluation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires assessment of ulcer stage and underlying conditions.
  • Treatment complexity: Involves multidisciplinary approaches including wound care, nutritional support, and possibly surgical intervention.
  • Documentation requirements: Detailed documentation of ulcer characteristics, patient history, and treatment plans is essential.
  • Coding specificity: While L89.149 is specific to the left lower back, it lacks detail on the ulcer stage, which may complicate coding.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcer stage or site.
  • Documentation gaps: Insufficient detail on ulcer assessment and treatment.
  • Billing challenges: Potential denials due to lack of specificity or incomplete documentation.

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

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CPT Code

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ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Pressure ulcers significantly impact patient quality of life and healthcare costs. They are associated with increased morbidity, prolonged hospital stays, and higher healthcare utilization. Effective management and prevention of pressure ulcers are critical for improving patient outcomes and reducing overall healthcare expenditures. Epidemiologically, pressure ulcers are prevalent in vulnerable populations, including the elderly and those with chronic illnesses, highlighting the need for targeted interventions and quality measures in healthcare settings.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient quality of life and healthcare costs. They are associated with increased morbidity, prolonged hospital stays, and higher healthcare utilization. Effective management and prevention of pressure ulcers are critical for improving patient outcomes and reducing overall healthcare expenditures. Epidemiologically, pressure ulcers are prevalent in vulnerable populations, including the elderly and those with chronic illnesses, highlighting the need for targeted interventions and quality measures in healthcare settings.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the ulcer, the complexity of care provided, and adherence to established guidelines. Common denials may arise from insufficient documentation or failure to demonstrate the medical necessity of the services rendered. Coders should ensure that all relevant clinical information is captured and that the treatment plan aligns with the documented diagnosis to minimize billing challenges.

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 L89.149?

L89.149 covers pressure ulcers located on the left lower back, regardless of the stage. It is important to note that the code does not specify the severity or depth of the ulcer, which may necessitate further evaluation and documentation.

When should L89.149 be used instead of related codes?

L89.149 should be used when documenting a pressure ulcer on the left lower back without a specified stage. If the ulcer's stage is known, more specific codes should be utilized to ensure accurate representation of the patient's condition.

What documentation supports L89.149?

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