L89.220 ICD-10-CM Code: Pressure ulcer of left hip, unstageable
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)
L89.220
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePressure ulcer of left hip, unstageable
A pressure ulcer on the left hip that cannot be staged or classified because the wound characteristics cannot be adequately assessed or documented.
Buddy Insight
Unstageable pressure ulcers of the left hip indicate wound beds obscured by eschar or slough, preventing accurate staging.
CMS-HCC V28
MappedHCC 381
RAF 0.0
CMS-HCC V24
MappedHCC 158
RAF 0.662
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 158
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for L89.220 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for L89.220 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for L89.220 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for L89.220 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for L89.220 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for L89.220 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for L89.220 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is L89.220 an HCC code?
Yes. L89.220 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 L89.220
For L89.220to 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 L89.220 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
L89.220 is the ICD-10-CM diagnosis code for pressure ulcer of left hip, unstageable. A pressure ulcer on the left hip that cannot be staged or classified because the wound characteristics cannot be adequately assessed or documented. L89.220 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, L89.220 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, L89.220 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.
Unstageable ulcers may have eschar, slough, or other factors preventing assessment; document the clinical reason for unsteageability. Because L89.220 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 L89.220 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Unstageable ulcers may have eschar, slough, or other factors preventing assessment; document the clinical reason for unsteageability
- •This is specific to the left hip; ensure laterality is correctly documented in the medical record
Clinical Significance
Unstageable pressure ulcers of the left hip indicate wound beds obscured by eschar or slough, preventing accurate staging. The left hip trochanteric area is a common pressure site in patients who prefer left lateral positioning. Unstageable designation raises concern for potentially severe underlying tissue destruction that warrants aggressive wound management and close monitoring.
Documentation Requirements
- ✓Anatomical location specified as left hip
- ✓Clinical reason for unstageable designation
- ✓Wound surface description and wound covering characteristics
- ✓Wound dimensions if assessable
- ✓Patient positioning and pressure redistribution documentation
- ✓Debridement and treatment plan
- ✓Reassessment timeline