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ICD-10 Guide
ICD-10 CodesL89.519

L89.519

Billable

Pressure ulcer of right ankle, unspecified stage

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

Code Description

ICD-10 L89.519 is a billable code used to indicate a diagnosis of pressure ulcer of right ankle, unspecified stage.

Key Diagnostic Point:

Pressure ulcers, also known as bedsores or decubitus ulcers, are localized injuries to the skin and underlying tissue, primarily caused by prolonged pressure, often over bony prominences. The right ankle is a common site for these ulcers due to its anatomical structure and the pressure exerted during immobility. Clinically, pressure ulcers can present as intact skin with non-blanchable redness or as open wounds with varying degrees of tissue loss. The disease progression can lead to serious complications, including infections and systemic issues if not properly managed. Diagnostic considerations include a thorough patient history, physical examination, and assessment of risk factors such as immobility, nutritional status, and comorbid conditions. The unspecified stage indicates that the exact depth of tissue damage is not determined, which can complicate treatment plans and prognosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires assessment of ulcer stage and risk factors.
  • Treatment complexity: Involves multidisciplinary approaches including wound care, nutrition, and possibly surgical intervention.
  • Documentation requirements: Detailed records of ulcer assessment, treatment plans, and patient progress are necessary.
  • Coding specificity: Requires accurate identification of the ulcer location and stage.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcer stage or location.
  • Documentation gaps: Incomplete records of ulcer assessment and treatment.
  • Billing challenges: Potential denials due to lack of specificity in documentation.

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

Pressure ulcers significantly impact patient quality of life and healthcare costs, leading to increased morbidity and extended hospital stays. They are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Effective management and prevention strategies are critical for reducing the incidence of pressure ulcers, improving patient outcomes, and minimizing healthcare utilization. Quality measures related to pressure ulcer prevention and management are increasingly emphasized in healthcare settings.

ICD-9 vs ICD-10

Pressure ulcers significantly impact patient quality of life and healthcare costs, leading to increased morbidity and extended hospital stays. They are prevalent in populations with limited mobility, such as the elderly and those with chronic illnesses. Effective management and prevention strategies are critical for reducing the incidence of pressure ulcers, improving patient outcomes, and minimizing healthcare utilization. Quality measures related to pressure ulcer prevention and management are increasingly emphasized in healthcare settings.

Reimbursement & Billing Impact

Reimbursement may depend on the specificity of the diagnosis code and the completeness of the medical record. Common denials can occur if documentation does not clearly support the diagnosis or if the treatment plan is not adequately outlined. Best practices include ensuring that all relevant details are recorded, including the ulcer's stage, size, and any interventions performed, to facilitate proper billing 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 L89.519?

L89.519 covers pressure ulcers located at the right ankle, where the specific stage of the ulcer is not documented. This includes any ulcer that has not been classified into stages 1 through 4 or unstageable.

When should L89.519 be used instead of related codes?

L89.519 should be used when the pressure ulcer at the right ankle is documented but the stage is not specified. If the stage is known, the appropriate specific code should be selected.

What documentation supports L89.519?

Documentation should include a detailed description of the ulcer's appearance, location, and any relevant patient history, including risk factors and treatment plans. Regular assessments and updates on the ulcer's condition are also essential.