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ICD-10 Guide
ICD-10 CodesL89.21

L89.21

Non-billable

Pressure ulcer of right hip

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

Code Description

ICD-10 L89.21 is a used to indicate a diagnosis of pressure ulcer of right hip.

Key Diagnostic Point:

L89.21 refers to a pressure ulcer located on the right hip, a common condition resulting from prolonged pressure on the skin, typically over bony prominences. Clinically, pressure ulcers can present as localized areas of skin breakdown, which may progress through various stages, from non-blanchable erythema to full-thickness tissue loss. The right hip, being a weight-bearing area, is particularly susceptible in individuals with limited mobility, such as the elderly or those with certain medical conditions. The anatomy involved includes the skin layers (epidermis, dermis) and subcutaneous tissue, which can become compromised due to ischemia. Disease progression can lead to serious complications, including infection and systemic illness. Diagnostic considerations include a thorough clinical assessment, staging of the ulcer, and evaluation of risk factors such as immobility, nutritional status, and comorbidities. Accurate diagnosis is essential for effective management and prevention strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical assessment and staging of the ulcer.
  • Treatment complexity: Involves multidisciplinary approaches including wound care, nutritional support, and possibly surgical intervention.
  • Documentation requirements: Detailed documentation of the ulcer's stage, size, and treatment plan is necessary.
  • Coding specificity: Requires precise coding to reflect the location and stage of the ulcer.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcer stage or site.
  • Documentation gaps: Incomplete records regarding ulcer assessment and treatment.
  • Billing challenges: Potential denials if documentation does not support the severity or treatment 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

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 and can lead to longer hospital stays and higher healthcare utilization. Epidemiologically, pressure ulcers are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Addressing this condition is essential for improving patient outcomes and reducing healthcare expenditures.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient quality of life and healthcare costs. They are associated with increased morbidity and can lead to longer hospital stays and higher healthcare utilization. Epidemiologically, pressure ulcers are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Addressing this condition is essential for improving patient outcomes and reducing healthcare expenditures.

Reimbursement & Billing Impact

Reimbursement may depend on the stage of the ulcer and the complexity of care required. Common denials can occur if documentation does not clearly support the diagnosis or if the treatment plan is not adequately detailed. Best practices include ensuring that all assessments, treatment plans, and follow-up care are well-documented and that coding accurately reflects the severity and location of the ulcer.

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 L89.21?

L89.21 specifically covers pressure ulcers that are located on the right hip. It includes ulcers that may be classified into different stages based on depth and tissue involvement, from stage I (non-blanchable erythema) to stage IV (full-thickness tissue loss).

When should L89.21 be used instead of related codes?

L89.21 should be used when the pressure ulcer is specifically located on the right hip. It is important to differentiate it from other codes that may refer to ulcers on different body parts or unspecified locations.

What documentation supports L89.21?

Documentation should include a detailed assessment of the ulcer, including its stage, size, and any associated symptoms. Additionally, records of treatment plans, patient mobility assessments, and risk factors should be included to support the diagnosis.