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ICD-10 Guide
ICD-10 CodesL89.201

L89.201

Billable

Pressure ulcer of unspecified hip, stage 1

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

Code Description

ICD-10 L89.201 is a billable code used to indicate a diagnosis of pressure ulcer of unspecified hip, stage 1.

Key Diagnostic Point:

L89.201 refers to a pressure ulcer of the unspecified hip, classified as stage 1. Pressure ulcers, also known as bedsores or decubitus ulcers, occur when sustained pressure on the skin reduces blood flow to the area, leading to tissue damage. Stage 1 pressure ulcers are characterized by intact skin with non-blanchable redness over a localized area, typically over a bony prominence. The hip region is particularly susceptible due to its anatomical structure and the weight-bearing nature of the area. Clinically, patients may present with localized warmth, edema, and discomfort. The progression of pressure ulcers can lead to more severe stages, including partial-thickness skin loss (stage 2), full-thickness skin loss (stage 3), and extensive tissue damage (stage 4). Diagnostic considerations include a thorough skin assessment, patient history, and risk factor evaluation, such as immobility, malnutrition, and moisture exposure. Early identification and intervention are crucial to prevent progression and complications, making accurate coding essential for effective treatment planning and resource allocation.

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

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

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 significantly impact patient morbidity and healthcare costs, leading to increased hospital stays and resource utilization. They are a key quality measure in healthcare settings, with a focus on prevention and management to improve patient outcomes. Understanding the epidemiology of pressure ulcers, particularly in vulnerable populations such as the elderly or immobile patients, is essential for effective healthcare planning and resource allocation.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient morbidity and healthcare costs, leading to increased hospital stays and resource utilization. They are a key quality measure in healthcare settings, with a focus on prevention and management to improve patient outcomes. Understanding the epidemiology of pressure ulcers, particularly in vulnerable populations such as the elderly or immobile patients, is essential for effective healthcare planning and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the need for comprehensive treatment plans that may involve wound care supplies and specialized services. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for treatment. Coders should ensure that all relevant clinical information is included in the patient's medical record to support the diagnosis and treatment provided.

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 L89.201?

L89.201 specifically covers stage 1 pressure ulcers located on the unspecified hip. It is important to note that this code does not apply to ulcers that have progressed to stage 2 or higher, nor does it cover ulcers located on other body parts.

When should L89.201 be used instead of related codes?

L89.201 should be used when documenting a stage 1 pressure ulcer on the hip when the specific side is not identified. If the ulcer is on the right or left hip, L89.202 or L89.203 should be used, respectively.

What documentation supports L89.201?

Documentation should include a detailed skin assessment, noting the stage of the ulcer, its location, and any contributing factors such as immobility or nutritional status. Photographic evidence and regular monitoring notes can also support the diagnosis.