L89.124 — Pressure ulcer of left upper back, stage 4
L89.124 is a billable, specific ICD-10-CM code for pressure ulcer of left upper back, stage 4. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Healing pressure ulcer of left upper back, stage 4
- Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, left upper back
Excludes2 inherited from the categories above L89.124
Also inherited, and the opposite of Excludes1: these conditions are not part of L89.124, but a patient can have both, so you may code both.
Risk adjustment
L89.124 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 379 Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone1.965 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.
Medicare coverage
L89.124 is named in 12 Medicare coverage policies — 10 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A52468Pressure Reducing Support Surfaces - Group 3- Policy Article
- A52490Pressure Reducing Support Surfaces - Group 2 - Policy Article
Code history
L89.124 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share L89.12. If L89.124 is not quite right, the correct code is usually one of these.
- L89.120Pressure ulcer of left upper back, unstageable
- L89.121Pressure ulcer of left upper back, stage 1
- L89.122Pressure ulcer of left upper back, stage 2
- L89.123Pressure ulcer of left upper back, stage 3
- L89.126Pressure-induced deep tissue damage of left upper back
- L89.129Pressure ulcer of left upper back, unspecified stage
Questions about L89.124
- Is L89.124 a billable ICD-10-CM code?
- Yes. L89.124 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L89.124 sit in the tabular list?
- Diseases of the skin and subcutaneous tissue (L00-L99), in the block Other disorders of the skin and subcutaneous tissue (L80-L99).