L89.133 ICD-10-CM Code: Pressure ulcer of right lower back, stage 3
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)
L89.133
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePressure ulcer of right lower back, stage 3
A stage 3 pressure ulcer on the right lower back where the skin and underlying tissue are damaged but the bone is not exposed.
Buddy Insight
Stage 3 pressure ulcers of the right lower back involve full-thickness skin loss extending into subcutaneous tissue, creating a deep crater-like wound.
CMS-HCC V28
MappedHCC 381
RAF 0.0
CMS-HCC V24
MappedHCC 158
RAF 0.662
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 158
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Healing pressure ulcer of right lower back, stage 3
- Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue, right lower back
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for L89.133 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for L89.133 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for L89.133 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for L89.133 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for L89.133 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for L89.133 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 L89.133 an HCC code?
Yes. L89.133 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
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 L89.133
For L89.133to 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 L89.133 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
L89.133 is the ICD-10-CM diagnosis code for pressure ulcer of right lower back, stage 3. A stage 3 pressure ulcer on the right lower back where the skin and underlying tissue are damaged but the bone is not exposed. L89.133 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, L89.133 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, L89.133 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.
Stage 3 indicates full-thickness skin loss with subcutaneous tissue involvement; bone/muscle not visible. Because L89.133 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 L89.133 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Stage 3 indicates full-thickness skin loss with subcutaneous tissue involvement; bone/muscle not visible
- •Document depth and any tunneling or undermining of surrounding tissue
Clinical Significance
Stage 3 pressure ulcers of the right lower back involve full-thickness skin loss extending into subcutaneous tissue, creating a deep crater-like wound. These represent significant tissue destruction at a weight-bearing surface that complicates patient positioning and mobility. The clinical complexity associated with stage 3 wounds includes risk of infection, need for specialized wound care, and potential for progression to stage 4.
Documentation Requirements
- ✓Exact anatomical location specified as right lower back
- ✓Stage explicitly documented as stage 3 by the provider
- ✓Wound depth and dimensions (length x width x depth)
- ✓Wound bed characteristics (granulation, slough, necrotic tissue)
- ✓Presence or absence of undermining/tunneling with measurements
- ✓Drainage type and amount
- ✓Signs of infection or complications
- ✓Wound care regimen and treatment plan
- ✓Nutritional support measures