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ICD-10 Guide
ICD-10 CodesL89.212

L89.212

Billable

Pressure ulcer of right hip, stage 2

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

Code Description

ICD-10 L89.212 is a billable code used to indicate a diagnosis of pressure ulcer of right hip, stage 2.

Key Diagnostic Point:

L89.212 refers to a stage 2 pressure ulcer located on the right hip. Clinically, a stage 2 pressure ulcer is characterized by partial thickness loss of skin, which may present as an abrasion, blister, or shallow crater. The ulcer involves the epidermis and may extend into the dermis, but does not penetrate through the underlying fascia. The right hip is a common site for pressure ulcers due to prolonged pressure, particularly in individuals with limited mobility or those who are bedridden. Disease progression can lead to deeper tissue damage if not properly managed, potentially advancing to stage 3 or 4 ulcers. Diagnostic considerations include a thorough assessment of the ulcer's characteristics, patient history, and risk factors such as immobility, malnutrition, and moisture exposure. Proper staging is crucial for treatment planning and monitoring healing progress, as well as for accurate coding and reimbursement purposes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

Specialty Focus

Medical Specialties

Wound care specialists

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

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

Related ICD-10 Codes

Related CPT Codes

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, including stage 2 ulcers like L89.212, have significant clinical implications, affecting patient quality of life and increasing healthcare costs. They are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Effective management of pressure ulcers can improve patient outcomes, reduce hospital stays, and enhance overall population health. Monitoring and addressing these conditions are critical for quality measures in healthcare settings.

ICD-9 vs ICD-10

Pressure ulcers, including stage 2 ulcers like L89.212, have significant clinical implications, affecting patient quality of life and increasing healthcare costs. They are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Effective management of pressure ulcers can improve patient outcomes, reduce hospital stays, and enhance overall population health. Monitoring and addressing these conditions are critical for quality measures in healthcare settings.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the ulcer and the complexity of care provided. Common denials may occur if documentation does not clearly support the diagnosis or if the treatment plan is not adequately detailed. Best practices include maintaining thorough records of assessments, treatment interventions, and patient progress to ensure compliance and reduce audit risks.

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 L89.212?

L89.212 specifically covers stage 2 pressure ulcers located on the right hip. It is important to differentiate this from other stages of pressure ulcers and other skin conditions that may present similarly.

When should L89.212 be used instead of related codes?

L89.212 should be used when documenting a stage 2 pressure ulcer on the right hip. It is crucial to use this code when the ulcer is confirmed to be stage 2, as using a different code may misrepresent the severity and treatment needs.

What documentation supports L89.212?

Documentation should include a detailed description of the ulcer's characteristics, staging, location, patient risk factors, and treatment plan. Photographic evidence and regular assessments can also support the coding.