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ICD-10 Guide
ICD-10 CodesL89.511

L89.511

Billable

Pressure ulcer of right ankle, stage 1

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

Code Description

ICD-10 L89.511 is a billable code used to indicate a diagnosis of pressure ulcer of right ankle, stage 1.

Key Diagnostic Point:

L89.511 refers to a stage 1 pressure ulcer located on the right ankle. Clinically, a stage 1 pressure ulcer is characterized by non-blanchable erythema of intact skin, which indicates localized damage to the skin and underlying tissue due to prolonged pressure. The right ankle, being a bony prominence, is particularly susceptible to pressure ulcers, especially in patients with limited mobility or those who are bedridden. The disease progression can lead to more severe stages of pressure ulcers if not properly managed, potentially resulting in significant morbidity. Diagnostic considerations include a thorough skin assessment, patient history, and risk factor evaluation, such as immobility, nutritional status, and comorbid conditions like diabetes or vascular disease. Early identification and intervention are crucial to prevent progression to more severe stages, which would require more complex treatment and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires assessment of skin integrity and risk factors.
  • Treatment complexity: Involves preventive measures and possible referral to wound care specialists.
  • Documentation requirements: Must include detailed descriptions of the ulcer's characteristics and patient risk factors.
  • Coding specificity: Requires precise coding to reflect the stage and location of the ulcer.

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 if documentation does not support the severity or stage of the ulcer.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Pressure ulcers, including stage 1 ulcers, significantly impact patient quality of life and healthcare costs. They are prevalent among hospitalized and long-term care patients, leading to increased healthcare utilization and potential complications. Effective management and prevention of pressure ulcers are critical quality measures in healthcare settings, influencing patient outcomes and institutional ratings.

ICD-9 vs ICD-10

Pressure ulcers, including stage 1 ulcers, significantly impact patient quality of life and healthcare costs. They are prevalent among hospitalized and long-term care patients, leading to increased healthcare utilization and potential complications. Effective management and prevention of pressure ulcers are critical quality measures in healthcare settings, influencing patient outcomes and institutional ratings.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the documentation supports the diagnosis and that the treatment plan is appropriate for the stage of the ulcer. Common denials may occur if there is insufficient evidence of the ulcer's stage or if preventive measures were not documented. Best practices include regular updates to the patient's chart and clear communication with the billing department to ensure all necessary information is included.

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 L89.511?

L89.511 specifically covers stage 1 pressure ulcers located on the right ankle. This includes any non-blanchable erythema of intact skin in that area, which may arise from prolonged pressure.

When should L89.511 be used instead of related codes?

L89.511 should be used when documenting a stage 1 pressure ulcer specifically on the right ankle. It is important to differentiate it from other stages or locations of pressure ulcers, which have their own specific codes.

What documentation supports L89.511?

Documentation should include a detailed description of the ulcer's characteristics, the patient's risk factors, and any preventive measures taken. Photographic evidence and regular assessments can also support the coding.