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ICD-10 Guide
ICD-10 CodesL89.319

L89.319

Billable

Pressure ulcer of right buttock, unspecified stage

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

Code Description

ICD-10 L89.319 is a billable code used to indicate a diagnosis of pressure ulcer of right buttock, unspecified stage.

Key Diagnostic Point:

L89.319 refers to a pressure ulcer located on the right buttock, classified as unspecified stage. Pressure ulcers, also known as bedsores or decubitus ulcers, occur due to prolonged pressure on the skin, typically in individuals with limited mobility. The right buttock is a common site for these ulcers due to the weight-bearing nature of this area when sitting or lying down. Clinically, pressure ulcers may present as localized areas of skin breakdown, which can range from non-blanchable erythema to full-thickness tissue loss. The disease progression can lead to serious complications such as infections, sepsis, and increased morbidity. Diagnostic considerations include a thorough patient history, physical examination, and assessment of risk factors such as immobility, nutritional status, and comorbidities. Accurate staging of pressure ulcers is crucial for treatment planning, but L89.319 is used when the stage is not specified, highlighting the need for further evaluation and documentation to determine the appropriate management strategy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires assessment of ulcer stage and risk factors.
  • Treatment complexity: Involves multidisciplinary approaches including wound care, nutrition, and possibly surgical intervention.
  • Documentation requirements: Must include detailed descriptions of the ulcer, staging, and patient risk factors.
  • Coding specificity: Requires precise coding to differentiate between stages and locations.

Audit Risk Factors

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

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CPT Code

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CPT Code

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Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Pressure ulcers significantly impact patient quality of life, leading to pain, increased healthcare utilization, and potential complications. They are a major concern in population health, particularly among elderly and immobile patients. Quality measures often include the prevention and management of pressure ulcers, reflecting their importance in healthcare settings. Epidemiologically, pressure ulcers are prevalent in long-term care facilities, highlighting the need for effective prevention strategies and comprehensive care plans.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient quality of life, leading to pain, increased healthcare utilization, and potential complications. They are a major concern in population health, particularly among elderly and immobile patients. Quality measures often include the prevention and management of pressure ulcers, reflecting their importance in healthcare settings. Epidemiologically, pressure ulcers are prevalent in long-term care facilities, highlighting the need for effective prevention strategies and comprehensive care plans.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the ulcer, the complexity of care, and the need for multidisciplinary interventions. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services rendered. Best practices include ensuring that all clinical notes are complete, detailing the ulcer's characteristics, and documenting the treatment plan and patient response to care.

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 L89.319?

L89.319 covers pressure ulcers located on the right buttock that are not specified by stage. This includes any ulcer that has not been classified into the defined stages of pressure ulcers, which range from stage I (non-blanchable erythema) to stage IV (full-thickness tissue loss).

When should L89.319 be used instead of related codes?

L89.319 should be used when the pressure ulcer on the right buttock is present but the stage is not documented. If the stage is known, a more specific code should be selected to accurately reflect the condition.

What documentation supports L89.319?

Documentation should include a detailed description of the ulcer's appearance, location, and any relevant patient history. It should also note risk factors such as immobility, nutritional status, and any previous history of pressure ulcers.