Dear Mrs. Smith,
The new ICD-10 codes for ulcers are essentially divided into “Non-pressure Chronic ulcers” and “Pressure ulcers.” Previously, we addressed codes for “Non-pressure Chronic ulcers” under the L97 category. In this second in a series of blogs, we focus on codes pertaining to ulcers caused by “Pressure.”
Pressure ulcer codes can be found under the L89 category which includes:
Bed sore, Decubitus ulcer, Plaster ulcer, Pressure area, Pressure sore and excludes:
1. Decubitus (trophic) ulcer of cervix (uteri) (N86)
2. Diabetic ulcers (E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621,E13.622)
3. Non-pressure chronic ulcer of skin (L97.-)
4. Skin infections (L00-L08)
5. Varicose ulcer (I83.0, I83.2)Pressure ulcer (pressure area) (L89.-)
6. Skin infections (L00. – L08.)
7. Specific infections classified to A00.-B99.
The L89 categories are divided by anatomical location:
L89.5 Pressure ulcer of ankle
L89.50 Pressure ulcer of unspecified ankle
L89.51 Pressure ulcer of right ankle
L89.52 Pressure ulcer of left ankle
L89.6 Pressure ulcer of heel
L89.60 Pressure ulcer of unspecified heel
L89.61 Pressure ulcer of right heel
L89.62 Pressure ulcer of left heel
L89.8 Pressure ulcer of other site
L89.9 Pressure ulcer of unspecified site
The L89 codes are further broken down to the level of tissue damage, using the NPUAP “Stages” including “unstageable” and “unspecified stage.” This is a significant change and the definitions for each stage are used in the following example:
L89.510 Pressure ulcer of right ankle, unstageable "Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed”
L89.511 Pressure ulcer of right ankle, stage 1 "Pressure pre-ulcer skin changes limited to persistent focal edema”
L89.512 Pressure ulcer of right ankle, stage 2
"Pressure ulcer with abrasion, blister, partial thickness skin loss involving epidermis and/or dermis”
L89.513 Pressure ulcer of right ankle, stage 3 "Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue”
L89.514 Pressure ulcer of right ankle, stage 4 "Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone”
L89.519 Pressure ulcer of right ankle, unspecified stage
To learn more about the NPUAP Stages and definitions, click here. In the next in this series of blogs, we will review the Debridement codes that took effect January 2011.
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