ED Coding and Reimbursement Alert

Question: If a patient has a pressure ulcer on their back, what is the difference among the stages, for coding purposes?

Missouri Subscriber

Answer: The stages of pressure ulcer represent the healing stages of the wound. If you’re worried about choosing among the stages, don’t be; ICD-10 lays out the characteristics of each stage.

Check out these possible ICD-10 codes for your patient, and what stage each code decides:

• L89.100 (Pressure ulcer of unspecified part of back, unstageable). Use this diagnosis code when the stage of the pressure ulcer is undetermined.
• L89.101 (Pressure ulcer of unspecified part of back, stage 1). Use this diagnosis code when the “pressure pre-ulcer skin changes limited to persistent focal edema, unspecified part of back,” according to ICD-10.
• L89.102 (Pressure ulcer of unspecified part of back, stage 2). Use this diagnosis code when the pressure ulcer contains “abrasion, blister, partial thickness skin loss involving epidermis and/or dermis, unspecified part of back,” according to ICD-10.
• L89.103 (Pressure ulcer of unspecified part of back, stage 3). Use this diagnosis code for a pressure ulcer “with full thickness skin loss involving damage or necrosis of subcutaneous tissue, unspecified part of back,” according to ICD-10.
• L89.104 (Pressure ulcer of unspecified part of back, stage 4). Use this diagnosis code for a pressure ulcer “with necrosis of soft tissues through to underlying muscle, tendon, or bone, unspecified part of back,” according to ICD-10.
• L89. 109 (Pressure ulcer of unspecified part of back, unspecified stage). Use this diagnosis code for a pressure ulcer with an unspecified stage. This is different from unstageable, in which the provider notes that the stage cannot be determined.