L89.204
BillablePressure ulcer of unspecified hip, stage 4
HCC Category Mapping
V28HCC 379 — Pressure Ulcer of Skin with Full Thickness Skin Loss
0.662V24HCC 157 — Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
1.071ESRDHCC 157 — Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
0.000What This Code Means
A stage 4 pressure ulcer on the hip representing the most severe type, with damage extending through all skin layers into muscle, bone, or other deep structures.
Coding Tips
- •Stage 4 is the most severe stage; document all exposed structures (muscle, bone, tendon, joint capsule) and wound characteristics
- •Specify laterality (left or right hip) and ensure thorough documentation of wound depth and extent
Clinical Significance
Stage 4 pressure ulcers of the unspecified hip are among the most severe wounds, with full-thickness tissue loss exposing bone, muscle, or tendon at a major weight-bearing joint. These wounds carry extreme risk for hip osteomyelitis, septic arthritis, and systemic infection. They often require surgical intervention and represent the highest clinical complexity for pressure ulcer management.
Documentation Requirements
- ✓Anatomical location specified as hip (query for laterality)
- ✓Stage explicitly documented as stage 4
- ✓Specific exposed structures identified
- ✓Complete wound dimensions
- ✓Undermining and tunneling extent
- ✓Evidence of osteomyelitis or deep infection
- ✓Imaging results (MRI, bone scan) if obtained
- ✓Wound cultures
- ✓Nutritional labs and intervention plan
- ✓Surgical consultation notes
Commonly Confused Codes
Code Hierarchy
└L89Pressure ulcer└L89.2Pressure ulcer of hip└L89.20Pressure ulcer of unspecified hip└L89.204Pressure ulcer of unspecified hip, stage 4
└L89.204Pressure ulcer of unspecified hip, stage 4