L89.100: Pressure ulcer of unspecified part of back, unstageable
L89.100 is a billable, specific ICD-10-CM code for pressure ulcer of unspecified part of back, unstageable. It is valid for submission on a claim.
Check L89.100 with the rest of the claim: free scrubberExcludes2 inherited from the categories above L89.100
Not part of this code, but both may be coded when both are present.
Risk adjustment
L89.100 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 381 Pressure Ulcer of Skin with Full Thickness Skin Loss1.075 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
L89.100 is named in 5 Medicare coverage policies: 3 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A52490Pressure Reducing Support Surfaces - Group 2 - Policy Article
- A53064Billing and Coding: Outpatient Occupational Therapy
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under L89.10
- L89.101Pressure ulcer of unspecified part of back, stage 1
- L89.102Pressure ulcer of unspecified part of back, stage 2
- L89.103Pressure ulcer of unspecified part of back, stage 3
- L89.104Pressure ulcer of unspecified part of back, stage 4
- L89.106Pressure-induced deep tissue damage of unspecified part of back
- L89.109Pressure ulcer of unspecified part of back, unspecified stage