L89.223 ICD-10-CM Code: Pressure ulcer of left hip, stage 3
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)
L89.223
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePressure ulcer of left hip, stage 3
A stage 3 pressure ulcer on the left hip, involving full-thickness skin loss that extends into the subcutaneous tissue but does not expose bone or muscle.
Buddy Insight
Stage 3 pressure ulcers of the left hip involve full-thickness skin loss extending into subcutaneous tissue.
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
Official- Healing pressure ulcer of left hip, stage 3
- Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue, left hip
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for L89.223 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for L89.223 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for L89.223 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for L89.223 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for L89.223 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for L89.223 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 L89.223 an HCC code?
Yes. L89.223 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 L89.223
For L89.223to 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 L89.223 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
L89.223 is the ICD-10-CM diagnosis code for pressure ulcer of left hip, stage 3. A stage 3 pressure ulcer on the left hip, involving full-thickness skin loss that extends into the subcutaneous tissue but does not expose bone or muscle. L89.223 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, L89.223 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, L89.223 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; document the depth and presence of undermining or tunneling if present. Because L89.223 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 L89.223 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; document the depth and presence of undermining or tunneling if present
- •Ensure documentation clearly indicates stage 3 severity; this stage may involve significant tissue damage requiring intensive wound care
Clinical Significance
Stage 3 pressure ulcers of the left hip involve full-thickness skin loss extending into subcutaneous tissue. The hip's limited soft tissue coverage makes these wounds particularly concerning because of the proximity to the hip joint and the potential for rapid progression. These indicate significant patient morbidity and require intensive wound management and nutritional support.
Documentation Requirements
- ✓Anatomical location specified as left hip
- ✓Stage explicitly documented as stage 3
- ✓Complete wound dimensions including depth
- ✓Wound bed characteristics and tissue types
- ✓Undermining or tunneling documentation
- ✓Drainage assessment
- ✓Signs of infection
- ✓Nutritional status
- ✓Comprehensive wound care plan