ICD-10 Guide

Skin Breakdown

ICD-10 Coding for Skin Breakdown(L89.152, L97.511)

PRIMARY SPECIALTYWound Care

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Skin Breakdown?

Essential facts and insights about Skin Breakdown

Key Clinical Considerations:

Presence of open wounds or ulcers on the skin
Assessment of wound size, depth, and exudate
Signs of infection such as redness, warmth, and purulent drainage

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history including risk factors (e.g., immobility, diabetes)
Detailed description of the wound including location and stage
Photographic evidence of the wound when applicable

Coding Guidelines

Usage Guidelines & Examples

Usage guidelines: Use specific codes based on wound type and severity.
Common errors: Misclassifying wound stage or failing to document comorbidities.

Code Exclusions

Important Exclusions

Excluded conditions: Burns, surgical wounds.
Alternative codes: Consider using codes for specific types of ulcers.

Specialty Focus

Primary Specialty

Wound Care

Specialty Applications

Patient populations: Elderly, bedridden patients, diabetic patients.
Clinical settings: Long-term care facilities, outpatient wound care clinics.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include detailed wound assessment and patient history.

Billing considerations?

Ensure accurate coding based on wound stage and treatment provided.

Skin Breakdown

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?

Skin Breakdown

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?