What is ICD-10 code L89.143?

L89.143 is the ICD-10-CM diagnosis code for Pressure ulcer of left lower back, stage 3. A stage 3 pressure sore on the left lower back with full-thickness skin loss extending into the subcutaneous tissue but not reaching muscle or bone. L89.143 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L89.143 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. L89.143 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. L89.143 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.

Which HCC does L89.143 map to under V28?

L89.143 maps to CMS-HCC V28 381 (Pressure Ulcer of Skin with Full Thickness Skin Loss). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does L89.143 pay in RAF?

L89.143 carries a community, non-dual, aged (CNA) RAF weight of 1.075 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for L89.143?

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 L89.143, V28 maps to Pressure Ulcer of Skin with Full Thickness Skin Loss at RAF 1.075 while V24 mapped to Pressure Ulcer of Skin with Full Thickness Skin Loss at RAF 1.069. Both models can still appear in legacy data and in payer-specific lookback periods.

What documentation supports L89.143?

Stage 3 shows full-thickness skin loss; document the depth, presence of undermining, and any visible subcutaneous fat Ensure the ulcer does not extend to muscle or bone, which would indicate stage 4 Because L89.143 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. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. MEAT is generic documentation evidence, not a payer-specific rule.

2026 ICD-10-CM L89.143: Pressure ulcer of left

L89.143 maps to CMS-HCC V28 381 (RAF 1.075). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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Code lookupL89.143Effective 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)

L89.143

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

Pressure ulcer of left lower back, stage 3

A stage 3 pressure sore on the left lower back with full-thickness skin loss extending into the subcutaneous tissue but not reaching muscle or bone.

Buddy Insight

Stage 3 pressure ulcers of the left lower back involve full-thickness skin loss with subcutaneous tissue damage, creating a deep wound.

CMS-HCC V28

Mapped

HCC 381

Pressure Ulcer of Skin with F...

RAF 1.075

CMS-HCC V24

Mapped

HCC 158

Pressure Ulcer of Skin with F...

RAF 1.069

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

Mapped

HCC 158

Pressure Ulcer of Skin with F...

RAF 0.158

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

L89.1Pressure ulcer of back

L89.14Pressure ulcer of left lower back

L89.143Pressure ulcer of left lower back, stage 3

Inclusion Terms

Official

Healing pressure ulcer of left lower back, stage 3
Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue, left lower back

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L89.143 in this effective period.

Related Child Codes

Official

L89.140Pressure ulcer of left lower back, unstageable

L89.141Pressure ulcer of left lower back, stage 1

L89.142Pressure ulcer of left lower back, stage 2

L89.144Pressure ulcer of left lower back, stage 4

L89.146Pressure-induced deep tissue damage of left lower back

Includes

Official

ICD-10-CM does not list Includes notes for L89.143 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L89.143 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L89.143 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L89.143 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L89.143 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Exact anatomical location specified as left lower back

Stage explicitly documented as stage 3

Wound depth and full dimensions

Wound bed characteristics (granulation tissue, slough percentage)

MEAT Support

HCC Buddy guidance

Exact anatomical location specified as left lower back

Stage explicitly documented as stage 3

Wound depth and full dimensions

Wound bed characteristics (granulation tissue, slough percentage)

Audit Caution

HCC Buddy guidance

Not distinguishing between visible subcutaneous fat (stage 3) and exposed muscle/bone (stage 4)

Coding stage 3 when documentation is vague about wound depth — query the provider for clarification

Missing undermining or tunneling documentation that could affect treatment and coding accuracy

Accepting wound care nurse staging without confirming it is consistent with the provider's assessment

Common Mistakes

HCC Buddy guidance

L89.144 — Stage 4 left lower back; bone, muscle, or tendon is exposed

L89.142 — Stage 2 left lower back; partial-thickness loss only

L89.140 — Unstageable left lower back; wound bed obscured

L89.133 — Stage 3 right lower back; laterality difference

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is L89.143 an HCC code?

Yes. L89.143 (Pressure ulcer of left lower back, stage 3) maps to Pressure Ulcer of Skin with Full Thickness Skin Loss under the CMS-HCC V28 risk adjustment model (and Pressure Ulcer of Skin with Full Thickness Skin Loss under V24), with a community non-dual aged RAF of 1.075. It is billable for payment year 2026.

Coder answer: L89.143 is billable and maps to V28 HCC 381, Pressure Ulcer of Skin with Full Thickness Skin Loss. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: L89.143
Description: Pressure ulcer of left lower back, stage 3
HCC (V28): HCC 381 — Pressure Ulcer of Skin with Full Thickness Skin Loss
RAF: 1.075
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 381, Pressure Ulcer of Skin with Full Thickness Skin Loss

1.075

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

1.069

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

0.158

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work L89.143 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for L89.143

For L89.143 to 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 L89.143 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

L89.143 is the ICD-10-CM diagnosis code for pressure ulcer of left lower back, stage 3. A stage 3 pressure sore on the left lower back with full-thickness skin loss extending into the subcutaneous tissue but not reaching muscle or bone. L89.143 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, L89.143 maps to Pressure Ulcer of Skin with Full Thickness Skin Loss (HCC 381) with a community, non-dual, aged base RAF weight of 1.075. Under the older V24 model, L89.143 mapped to the same category but with a base RAF weight of 1.069, V28 recalibrated weights across the entire model. 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 shows full-thickness skin loss; document the depth, presence of undermining, and any visible subcutaneous fat. Because L89.143 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 L89.143 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Stage 3 shows full-thickness skin loss; document the depth, presence of undermining, and any visible subcutaneous fat
•Ensure the ulcer does not extend to muscle or bone, which would indicate stage 4

Clinical Significance

Stage 3 pressure ulcers of the left lower back involve full-thickness skin loss with subcutaneous tissue damage, creating a deep wound. These wounds are clinically significant because they represent a major escalation in tissue destruction requiring specialized wound care, nutritional support, and infection monitoring. The left lower back location can complicate patient positioning and pressure relief strategies.