What is ICD-10 code L89.130?

L89.130 is the ICD-10-CM diagnosis code for Pressure ulcer of right lower back, unstageable. A pressure ulcer on the right lower back that cannot be staged because the wound bed is covered with eschar or slough that prevents visualization. L89.130 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L89.130 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. L89.130 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. L89.130 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for L89.130?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For L89.130, V28 maps to Pressure Ulcer of Skin, Unstageable/Unspecified at RAF 0.000 while V24 mapped to Pressure Ulcer of Skin with Full Thickness Skin Loss at RAF 0.662. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting L89.130?

Unstageable ulcers typically have non-removable dressings or necrotic tissue obscuring the wound bed Document the reason why staging is not possible (eschar, slough, etc.) Because L89.130 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

L89.130 ICD-10 Code: Pressure ulcer of right lower

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupL89.130Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)

L89.130

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Pressure ulcer of right lower back, unstageable

A pressure ulcer on the right lower back that cannot be staged because the wound bed is covered with eschar or slough that prevents visualization.

Buddy Insight

Unstageable pressure ulcers of the right lower back indicate wound beds that cannot be assessed for depth due to eschar, slough, or other clinical factors.

CMS-HCC V28

Mapped

HCC 381

Pressure Ulcer of Skin, Unsta...

RAF 0.0

CMS-HCC V24

Mapped

HCC 158

Pressure Ulcer of Skin with F...

RAF 0.662

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 158

Pressure Ulcer of Skin with F...

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

L89.1Pressure ulcer of back

L89.13Pressure ulcer of right lower back

L89.130Pressure ulcer of right lower back, unstageable

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for L89.130 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L89.130 in this effective period.

Related Child Codes

Official

L89.131Pressure ulcer of right lower back, stage 1

L89.132Pressure ulcer of right lower back, stage 2

L89.133Pressure ulcer of right lower back, stage 3

L89.134Pressure ulcer of right lower back, stage 4

L89.136Pressure-induced deep tissue damage of right lower back

Includes

Official

ICD-10-CM does not list Includes notes for L89.130 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L89.130 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L89.130 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L89.130 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L89.130 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Exact anatomical location specified as right lower back

Clinical reason why staging cannot be performed (eschar, slough, non-removable dressing)

Description of wound bed appearance and surrounding tissue

Wound dimensions if measurable

MEAT Support

HCC Buddy guidance

Exact anatomical location specified as right lower back

Clinical reason why staging cannot be performed (eschar, slough, non-removable dressing)

Description of wound bed appearance and surrounding tissue

Wound dimensions if measurable

Audit Caution

HCC Buddy guidance

Confusing 'unstageable' with 'unspecified stage' — these are clinically distinct concepts

Continuing to code unstageable after debridement when the wound bed is now visible and can be staged

Using unstageable for deep tissue pressure injuries, which have their own specific codes

Not specifying laterality when documentation clearly states right side

Common Mistakes

HCC Buddy guidance

L89.133 — Stage 3 right lower back; use when full-thickness loss is confirmed without bone/muscle exposure

L89.134 — Stage 4 right lower back; use when deep structures are exposed

L89.140 — Unstageable left lower back; laterality difference

L89.139 — Unspecified stage right lower back; use when stage is simply not documented

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is L89.130 an HCC code?

Yes. L89.130 maps to Pressure Ulcer of Skin, Unstageable/Unspecified under the CMS-HCC V28 risk adjustment model (and Pressure Ulcer of Skin with Full Thickness Skin Loss under V24).

HCC Category Mapping

V28HCC 381, Pressure Ulcer of Skin, Unstageable/Unspecified

0.000

V24HCC 158, Pressure Ulcer of Skin with Full Thickness Skin Loss

0.662

ESRDHCC 158, Pressure Ulcer of Skin with Full Thickness Skin Loss

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for L89.130

For L89.130to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed L89.130 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

L89.130 is the ICD-10-CM diagnosis code for pressure ulcer of right lower back, unstageable. A pressure ulcer on the right lower back that cannot be staged because the wound bed is covered with eschar or slough that prevents visualization. L89.130 sits in the ICD-10-CM chapter for diseases of the skin and subcutaneous tissue (l00-l99), within the section covering other disorders of the skin and subcutaneous tissue (l80-l99).

Under the CMS-HCC V28 risk adjustment model, L89.130 maps to Pressure Ulcer of Skin, Unstageable/Unspecified (HCC 381) with a community, non-dual, aged base RAF weight of 0.000. Under the older CMS-HCC V24 model, L89.130 maps to Pressure Ulcer of Skin with Full Thickness Skin Loss (HCC 158) with a community, non-dual, aged base RAF weight of 0.662. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Unstageable ulcers typically have non-removable dressings or necrotic tissue obscuring the wound bed. Because L89.130 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L89.130 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Unstageable ulcers typically have non-removable dressings or necrotic tissue obscuring the wound bed
•Document the reason why staging is not possible (eschar, slough, etc.)

Clinical Significance

Unstageable pressure ulcers of the right lower back indicate wound beds that cannot be assessed for depth due to eschar, slough, or other clinical factors. The right lower back is a common pressure point in bedridden patients, particularly over the iliac crest region. These wounds require serial reassessment as debridement reveals the true wound depth, which may ultimately prove to be stage 3 or 4.

Documentation Requirements

✓Exact anatomical location specified as right lower back
✓Clinical reason why staging cannot be performed (eschar, slough, non-removable dressing)
✓Description of wound bed appearance and surrounding tissue
✓Wound dimensions if measurable
✓Current treatment plan and debridement strategy
✓Assessment of pressure redistribution measures in place
✓Provider's monitoring and reassessment plan

Commonly Confused Codes

•L89.133: Stage 3 right lower back; use when full-thickness loss is confirmed without bone/muscle exposure
•L89.134: Stage 4 right lower back; use when deep structures are exposed
•L89.140: Unstageable left lower back; laterality difference
•L89.139: Unspecified stage right lower back; use when stage is simply not documented