L89.43 — Pressure ulcer of contiguous site of back, buttock and hip, stage 3
L89.43 is a billable, specific ICD-10-CM code for pressure ulcer of contiguous site of back, buttock and hip, stage 3. 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 contiguous site of back, buttock and hip, stage 3
- Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue, contiguous site of back, buttock and hip
Excludes2 inherited from the categories above L89.43
Also inherited, and the opposite of Excludes1: these conditions are not part of L89.43, but a patient can have both, so you may code both.
Risk adjustment
L89.43 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.
Medicare coverage
L89.43 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
L89.43 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 L89.4. If L89.43 is not quite right, the correct code is usually one of these.
- L89.40Pressure ulcer of contiguous site of back, buttock and hip, unspecified stage
- L89.41Pressure ulcer of contiguous site of back, buttock and hip, stage 1
- L89.42Pressure ulcer of contiguous site of back, buttock and hip, stage 2
- L89.44Pressure ulcer of contiguous site of back, buttock and hip, stage 4
- L89.45Pressure ulcer of contiguous site of back, buttock and hip, unstageable
- L89.46Pressure-induced deep tissue damage of contiguous site of back, buttock and hip
Questions about L89.43
- Is L89.43 a billable ICD-10-CM code?
- Yes. L89.43 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L89.43 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).