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ICD-10 Guide
ICD-10 CodesL89.211

L89.211

Billable

Pressure ulcer of right hip, stage 1

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

Code Description

ICD-10 L89.211 is a billable code used to indicate a diagnosis of pressure ulcer of right hip, stage 1.

Key Diagnostic Point:

L89.211 refers to a stage 1 pressure ulcer located on the right hip. Clinically, a stage 1 pressure ulcer is characterized by non-blanchable erythema of intact skin, indicating localized damage to the skin and underlying tissue due to prolonged pressure. The right hip is a common site for pressure ulcers, particularly in individuals with limited mobility or those who are bedridden. The anatomy involved includes the epidermis and dermis, where the skin may appear red and may feel warmer or cooler compared to surrounding tissue. Disease progression can lead to more severe stages of pressure ulcers if not addressed promptly, potentially resulting in deeper tissue damage. Diagnostic considerations include a thorough skin assessment, patient history, and risk factor evaluation, such as immobility, nutritional status, and comorbid conditions. Early identification and intervention are crucial to prevent progression to higher stages of pressure ulcers, which can complicate treatment and recovery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful assessment of skin integrity and risk factors.
  • Treatment complexity: Involves multidisciplinary approaches including wound care and possibly surgical intervention for advanced stages.
  • Documentation requirements: Detailed documentation of the ulcer's characteristics and patient history is essential.
  • Coding specificity: Requires accurate 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 of ulcer assessment or treatment plans.
  • 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of accurately coding L89.211 lies in its role in tracking the incidence of pressure ulcers, which are a major concern in healthcare settings, particularly among vulnerable populations. Effective management of pressure ulcers can improve patient outcomes, reduce healthcare costs, and enhance quality measures related to wound care. Understanding the epidemiology of pressure ulcers helps healthcare providers implement preventive strategies, ultimately impacting population health and resource utilization.

ICD-9 vs ICD-10

The clinical significance of accurately coding L89.211 lies in its role in tracking the incidence of pressure ulcers, which are a major concern in healthcare settings, particularly among vulnerable populations. Effective management of pressure ulcers can improve patient outcomes, reduce healthcare costs, and enhance quality measures related to wound care. Understanding the epidemiology of pressure ulcers helps healthcare providers implement preventive strategies, ultimately impacting population health and resource utilization.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the ulcer is being actively treated and monitored. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for treatment. Best practices include maintaining thorough records of assessments, treatment plans, and patient progress to support claims and reduce the risk of audits.

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 L89.211?

L89.211 specifically covers stage 1 pressure ulcers located on the right hip. It is important to differentiate this from other skin conditions or ulcers that may not be pressure-related.

When should L89.211 be used instead of related codes?

L89.211 should be used when documenting a stage 1 pressure ulcer on the right hip. If the ulcer progresses to a higher stage or occurs in a different location, corresponding codes should be selected.

What documentation supports L89.211?

Documentation should include a detailed description of the ulcer's appearance, location, stage, and any relevant patient history, including risk factors for pressure ulcer development.