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ICD-10 Guide
ICD-10 CodesL89.313

L89.313

Billable

Pressure ulcer of right buttock, stage 3

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

Code Description

ICD-10 L89.313 is a billable code used to indicate a diagnosis of pressure ulcer of right buttock, stage 3.

Key Diagnostic Point:

L89.313 refers to a stage 3 pressure ulcer located on the right buttock. Pressure ulcers, also known as bedsores or decubitus ulcers, occur due to prolonged pressure on the skin, typically in individuals with limited mobility. Clinically, a stage 3 pressure ulcer is characterized by full-thickness skin loss, which may extend into the subcutaneous tissue but not through the underlying fascia. The ulcer may present with necrotic tissue, slough, or eschar, and may exhibit drainage. The right buttock is a common site for these ulcers due to the pressure exerted when sitting or lying down. Disease progression can lead to deeper tissue damage, potentially resulting in stage 4 ulcers, which involve muscle, bone, or supporting structures. Diagnostic considerations include a thorough assessment of the ulcer's depth, size, and surrounding skin condition, as well as the patient's overall health status and mobility limitations. Proper staging is crucial for effective treatment planning and monitoring of healing progress.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of ulcer stage
  • Documentation gaps may arise from insufficient detail on ulcer assessment
  • Billing challenges can occur if treatment plans do not align with the documented severity of the ulcer

Specialty Focus

Medical Specialties

Wound care specialists

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

Dermatologists

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. Effective management and prevention of pressure ulcers are critical for improving patient outcomes and reducing the burden on healthcare systems. Epidemiologically, pressure ulcers are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses.

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. Effective management and prevention of pressure ulcers are critical for improving patient outcomes and reducing the burden on healthcare systems. Epidemiologically, pressure ulcers are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the ulcer and the complexity of care provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the treatment provided. Best practices include ensuring that all treatment interventions are well-documented and align with the coding for the ulcer stage to avoid discrepancies during 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 L89.313?

L89.313 specifically covers stage 3 pressure ulcers on the right buttock. This includes ulcers that exhibit full-thickness skin loss with possible necrotic tissue but do not extend through underlying fascia.

When should L89.313 be used instead of related codes?

L89.313 should be used when documenting a stage 3 pressure ulcer specifically located on the right buttock. It is important to differentiate from stage 1 and stage 2 ulcers, which have different characteristics and treatment protocols.

What documentation supports L89.313?

Documentation should include a detailed description of the ulcer's size, depth, and appearance, as well as the patient's mobility status, risk factors for ulcer development, and any treatment interventions being utilized.