L89.153
BillablePressure ulcer of sacral region, stage 3
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is L89.153 an HCC code?
Yes. L89.153 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 L89.153
For L89.153 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 L89.153 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
L89.153 is the ICD-10-CM diagnosis code for pressure ulcer of sacral region, stage 3. A stage 3 pressure ulcer on the sacral region where the skin and underlying tissue are significantly damaged, creating a deep crater-like wound. L89.153 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, L89.153 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, L89.153 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 represents full-thickness skin loss extending into subcutaneous tissue; document presence of undermining or tunneling if present. Because L89.153 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 L89.153 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Stage 3 represents full-thickness skin loss extending into subcutaneous tissue; document presence of undermining or tunneling if present
- •Verify clinical documentation confirms depth and extent before coding stage 3 to avoid under- or over-coding
Clinical Significance
Stage 3 sacral pressure ulcers represent full-thickness skin loss at the body's most common pressure ulcer site. The sacrum's thin tissue layer means stage 3 wounds can rapidly progress to stage 4 with bone exposure. These wounds are clinically significant indicators of patient frailty, immobility, and often malnutrition, requiring comprehensive multidisciplinary care.
Documentation Requirements
- ✓Anatomical location specified as sacral region
- ✓Stage explicitly documented as stage 3
- ✓Wound depth and complete dimensions
- ✓Wound bed description (granulation tissue, slough, necrotic tissue percentages)
- ✓Undermining or tunneling with clock-face directional measurements
- ✓Drainage characteristics and volume
- ✓Signs of wound infection
- ✓Nutritional assessment and interventions
- ✓Wound care treatment plan and products used
- ✓Pressure redistribution surface documentation