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ICD-10 Guide
ICD-10 CodesL89.514

L89.514

Billable

Pressure ulcer of right ankle, stage 4

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

Code Description

ICD-10 L89.514 is a billable code used to indicate a diagnosis of pressure ulcer of right ankle, stage 4.

Key Diagnostic Point:

L89.514 refers to a stage 4 pressure ulcer located on the right ankle. 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 4 ulcers are characterized by full-thickness tissue loss, exposing muscle, bone, or supporting structures such as tendons or joints. Clinically, these ulcers may present with necrotic tissue and significant drainage, often accompanied by infection. The right ankle's anatomy includes skin, subcutaneous tissue, and underlying structures, making it susceptible to pressure ulcers, especially in patients with limited mobility or chronic conditions. Disease progression can lead to severe complications, including systemic infections and sepsis if not managed appropriately. Diagnostic considerations include a thorough clinical assessment, staging of the ulcer, and evaluation for comorbidities that may affect healing, such as diabetes or vascular disease.

Code Complexity Analysis

Complexity Rating: High

High 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 if the extent of tissue damage is not clearly described.
  • Billing challenges can occur if the treatment plan is not adequately documented.

Specialty Focus

Medical Specialties

Wound Care

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Pressure ulcers, particularly stage 4, have significant clinical implications, including increased morbidity and healthcare costs. They are prevalent in populations with limited mobility, such as the elderly or those with chronic illnesses. Effective management of pressure ulcers is crucial for improving patient outcomes, reducing hospital stays, and enhancing quality measures in healthcare settings. Understanding the epidemiology of pressure ulcers can help healthcare providers implement preventive strategies and allocate resources effectively.

ICD-9 vs ICD-10

Pressure ulcers, particularly stage 4, have significant clinical implications, including increased morbidity and healthcare costs. They are prevalent in populations with limited mobility, such as the elderly or those with chronic illnesses. Effective management of pressure ulcers is crucial for improving patient outcomes, reducing hospital stays, and enhancing quality measures in healthcare settings. Understanding the epidemiology of pressure ulcers can help healthcare providers implement preventive strategies and allocate resources effectively.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed clinical notes that justify the level of care provided. Common denials may arise from insufficient documentation or incorrect coding of the ulcer stage. Best practices include ensuring that all treatment modalities, such as debridement or wound care supplies, are clearly documented and linked to the diagnosis to support claims.

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 L89.514?

L89.514 specifically covers stage 4 pressure ulcers located on the right ankle. It is important to document the ulcer's characteristics, including size, depth, and any signs of infection, to support the diagnosis.

When should L89.514 be used instead of related codes?

L89.514 should be used when documenting a stage 4 pressure ulcer on the right ankle. Other related codes may apply to different stages or locations of pressure ulcers, so accurate staging and localization are critical for proper code selection.

What documentation supports L89.514?

Documentation should include a detailed description of the ulcer's stage, size, depth, and any associated symptoms such as drainage or infection. Additionally, the patient's medical history, mobility status, and any interventions should be recorded to support the diagnosis.