L89.613 — Pressure ulcer of right heel, stage 3
L89.613 is a billable, specific ICD-10-CM code for pressure ulcer of right heel, 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 right heel, stage 3
- Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue, right heel
Risk adjustment
L89.613 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
L89.613 is named in 11 Medicare coverage policies — 9 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
- A53057Billing and Coding: Home Health Occupational Therapy
Related codes at this level
Codes that share L89.61. If L89.613 is not quite right, the correct code is usually one of these.
Questions about L89.613
- Is L89.613 a billable ICD-10-CM code?
- Yes. L89.613 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does L89.613 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).