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ICD-10 Guide
ICD-10 CodesL89.11

L89.11

Non-billable

Pressure ulcer of right upper back

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

Code Description

ICD-10 L89.11 is a used to indicate a diagnosis of pressure ulcer of right upper back.

Key Diagnostic Point:

L89.11 refers to a pressure ulcer located on the right upper back, classified under the category of pressure ulcers, which are localized injuries to the skin and/or underlying tissue. These ulcers typically occur due to prolonged pressure, often in patients with limited mobility or those who are bedridden. The right upper back, being a common site for pressure ulcers, can be affected by factors such as shear, friction, and moisture. Clinically, these ulcers can present as intact skin with non-blanchable redness or as open wounds with varying degrees of tissue loss. Disease progression can lead to deeper tissue damage, potentially resulting in complications such as infections. Diagnostic considerations include assessing the ulcer stage, which ranges from Stage I (non-blanchable erythema) to Stage IV (full-thickness tissue loss). Proper assessment and documentation are crucial for effective treatment planning and coding accuracy.

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

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

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 significantly impact patient quality of life and healthcare costs. They are associated with increased morbidity, prolonged hospital stays, and higher healthcare utilization. Understanding the epidemiology of pressure ulcers, particularly in vulnerable populations, is crucial for implementing effective prevention strategies and improving overall patient outcomes.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient quality of life and healthcare costs. They are associated with increased morbidity, prolonged hospital stays, and higher healthcare utilization. Understanding the epidemiology of pressure ulcers, particularly in vulnerable populations, is crucial for implementing effective prevention strategies and improving overall patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the stage of the ulcer, treatment provided, and any associated complications. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining thorough clinical notes, ensuring accurate coding, and regularly reviewing payer guidelines to avoid billing challenges.

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 L89.11?

L89.11 specifically covers pressure ulcers located on the right upper back. It includes various stages of pressure ulcers, from Stage I to Stage IV, depending on the severity and depth of the tissue damage.

When should L89.11 be used instead of related codes?

L89.11 should be used when documenting a pressure ulcer specifically located on the right upper back. It is important to differentiate it from other codes that pertain to different locations or stages of pressure ulcers.

What documentation supports L89.11?

Documentation should include a detailed description of the ulcer's location, stage, size, and any associated symptoms. Clinical assessments, treatment plans, and progress notes are essential to support the use of L89.11.