Pressure ulcer of right buttock, stage 4
ICD-10 L89.314 is a billable code used to indicate a diagnosis of pressure ulcer of right buttock, stage 4.
L89.314 refers to a stage 4 pressure ulcer located on the right buttock. Clinically, a stage 4 pressure ulcer is characterized by full-thickness tissue loss, which may extend into muscle, bone, or supporting structures. The ulcer may present with necrotic tissue, slough, or eschar, and often involves significant tissue damage. The right buttock is anatomically significant as it is a common site for pressure ulcers due to prolonged pressure, particularly in individuals with limited mobility or those who are bedridden. Disease progression can lead to severe complications, including infections, sepsis, and increased morbidity. Diagnostic considerations include a thorough clinical examination, assessment of the ulcer stage, and evaluation of the patient's overall health status, including nutritional assessment and comorbid conditions that may impede healing. Proper staging and documentation are crucial for effective treatment planning and reimbursement.
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
Standard ICD-10-CM documentation requirements apply
Various clinical presentations within this specialty area
Follow specialty-specific billing guidelines
L89.314 specifically covers stage 4 pressure ulcers on the right buttock, which may include complications such as infection or osteomyelitis. It is essential to document the ulcer's characteristics and any associated conditions.
L89.314 should be used when the pressure ulcer is confirmed as stage 4 on the right buttock, differentiating it from lower stages (L89.313 for stage 3) based on the extent of tissue damage and clinical findings.
Documentation should include a detailed assessment of the ulcer, including size, depth, presence of necrotic tissue, and any signs of infection. Additionally, a comprehensive patient history and treatment plan are necessary to support the diagnosis.
