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L89.159

Billable

Pressure ulcer of sacral region, unspecified stage

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is L89.159 an HCC code?

No. L89.159 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

L89.159 is the ICD-10-CM diagnosis code for pressure ulcer of sacral region, unspecified stage. A pressure ulcer on the sacral region where the stage or severity level has not been determined or documented. L89.159 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).

L89.159 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Use this code only when stage cannot be determined from clinical documentation; query provider for stage information when possible.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for L89.159 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when stage cannot be determined from clinical documentation; query provider for stage information when possible
  • This is a less specific code; attempt to obtain stage information to assign a more precise code

Code Hierarchy

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