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ICD-10 Guide
ICD-10 CodesL89.224

L89.224

Billable

Pressure ulcer of left hip, stage 4

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

Code Description

ICD-10 L89.224 is a billable code used to indicate a diagnosis of pressure ulcer of left hip, stage 4.

Key Diagnostic Point:

L89.224 refers to a stage 4 pressure ulcer located on the left hip, characterized by full-thickness tissue loss, which may involve exposure of muscle, bone, or supporting structures. Clinically, these ulcers present as deep, open wounds with necrotic tissue and may be accompanied by significant pain and infection. The left hip is anatomically significant as it bears weight and is subject to pressure, particularly in immobile patients. Disease progression can lead to severe complications, including systemic infections and prolonged hospitalization. Diagnostic considerations include a thorough clinical assessment, staging of the ulcer, and evaluation for comorbid conditions such as diabetes or vascular disease that may impede healing. Accurate staging is crucial, as it informs treatment strategies and prognosis. Regular monitoring and reassessment are essential to manage the ulcer effectively and prevent further deterioration.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires detailed assessment of ulcer stage and underlying conditions.
  • Treatment complexity: Involves multidisciplinary approaches including wound care, nutritional support, and possibly surgical intervention.
  • Documentation requirements: Necessitates comprehensive documentation of ulcer characteristics, treatment plans, and patient progress.
  • Coding specificity: Requires precise coding to reflect the specific location and stage of the ulcer.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcer stage or location.
  • Documentation gaps: Incomplete records regarding ulcer assessment and treatment history.
  • Billing challenges: Potential denials due to lack of supporting documentation for severity and treatment.

Specialty Focus

Medical Specialties

Wound Care

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, particularly stage 4, have significant clinical implications, leading to increased morbidity and healthcare costs. They are prevalent in populations with limited mobility, such as the elderly or those with chronic illnesses. Effective management of these ulcers is crucial for improving patient outcomes and reducing hospital readmissions. Quality measures related to pressure ulcer prevention and treatment are increasingly emphasized in healthcare settings, impacting reimbursement and care protocols.

ICD-9 vs ICD-10

Pressure ulcers, particularly stage 4, have significant clinical implications, leading to increased morbidity and healthcare costs. They are prevalent in populations with limited mobility, such as the elderly or those with chronic illnesses. Effective management of these ulcers is crucial for improving patient outcomes and reducing hospital readmissions. Quality measures related to pressure ulcer prevention and treatment are increasingly emphasized in healthcare settings, impacting reimbursement and care protocols.

Reimbursement & Billing Impact

reimbursement and care protocols.

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 L89.224?

L89.224 specifically covers stage 4 pressure ulcers on the left hip, which may include conditions such as necrotizing fasciitis or osteomyelitis if bone is exposed.

When should L89.224 be used instead of related codes?

L89.224 should be used when the pressure ulcer is confirmed as stage 4 on the left hip, differentiating it from lower stage ulcers which have less tissue loss.

What documentation supports L89.224?

Documentation should include detailed descriptions of the ulcer's size, depth, stage, and any signs of infection, as well as treatment plans and patient responses.