L89.150
BillablePressure ulcer of sacral region, unstageable
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is L89.150 an HCC code?
Yes. L89.150 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 L89.150
For L89.150 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 L89.150 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
L89.150 is the ICD-10-CM diagnosis code for pressure ulcer of sacral region, unstageable. A pressure sore in the sacral region (base of spine/tailbone area) that cannot be staged due to unclear wound characteristics or treatment that obscures staging. L89.150 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, L89.150 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, L89.150 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.
Sacral pressure ulcers are among the most common; ensure documentation specifies sacral region versus buttock or lower back. Because L89.150 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 L89.150 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Sacral pressure ulcers are among the most common; ensure documentation specifies sacral region versus buttock or lower back
- •Unstageable designation requires documentation of the reason (eschar, necrotic tissue, or inability to assess)
Clinical Significance
Unstageable pressure ulcers of the sacral region are among the most clinically encountered pressure injuries, as the sacrum is the single most common pressure ulcer site. The inability to stage suggests eschar or slough coverage that may be masking stage 3 or 4 depth. Given the sacrum's bony prominence with minimal overlying soft tissue, these wounds warrant close monitoring and aggressive wound management.
Documentation Requirements
- ✓Anatomical location specified as sacral region (not coccyx, not buttock)
- ✓Clinical reason for unstageable designation (eschar, slough, non-removable dressing)
- ✓Description of wound surface and surrounding tissue
- ✓Wound dimensions if assessable
- ✓Presence of drainage or odor
- ✓Debridement plan or rationale for wound management approach
- ✓Pressure redistribution strategy and support surface documentation
- ✓Provider reassessment plan for staging when wound bed becomes visible
Commonly Confused Codes
- •L89.153 — Stage 3 sacral region; use when full-thickness loss is confirmed without deep structure exposure
- •L89.154 — Stage 4 sacral region; use when bone, muscle, or tendon is exposed
- •L89.300 — Unstageable unspecified buttock; different anatomical site
- •L89.45 — Unstageable contiguous site of back, buttock, and hip; use when ulcer spans multiple areas
- •L89.159 — Unspecified stage sacral region; stage not documented, distinct from clinically unstageable