L89.224 ICD-10-CM Code: Pressure ulcer of left hip, stage 4
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)
L89.224
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePressure ulcer of left hip, stage 4
A stage 4 pressure ulcer on the left hip, the most severe stage involving full-thickness skin loss with exposure of underlying bone, muscle, or supporting structures.
Buddy Insight
Stage 4 pressure ulcers of the left hip are the most severe classification, with full-thickness tissue loss exposing bone, tendon, muscle, or joint capsule.
CMS-HCC V28
MappedHCC 379
RAF 0.662
CMS-HCC V24
MappedHCC 157
RAF 1.071
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 157
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 4
- Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, left hip
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for L89.224 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for L89.224 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for L89.224 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for L89.224 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for L89.224 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for L89.224 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 L89.224 an HCC code?
Yes. L89.224 maps to Pressure Ulcer of Skin with Full Thickness Skin Loss under the CMS-HCC V28 risk adjustment model (and Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone 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 L89.224
For L89.224to 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 L89.224 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
L89.224 is the ICD-10-CM diagnosis code for pressure ulcer of left hip, stage 4. A stage 4 pressure ulcer on the left hip, the most severe stage involving full-thickness skin loss with exposure of underlying bone, muscle, or supporting structures. L89.224 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, L89.224 maps to Pressure Ulcer of Skin with Full Thickness Skin Loss (HCC 379) with a community, non-dual, aged base RAF weight of 0.662. Under the older CMS-HCC V24 model, L89.224 maps to Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone (HCC 157) with a community, non-dual, aged base RAF weight of 1.071. 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 4 is the most severe; document exposure of bone, muscle, tendon, or other structures; note any necrotic tissue present. Because L89.224 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 L89.224 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Stage 4 is the most severe; document exposure of bone, muscle, tendon, or other structures; note any necrotic tissue present
- •Verify that the ulcer extends beyond subcutaneous tissue to qualify as stage 4; this requires comprehensive wound documentation
Clinical Significance
Stage 4 pressure ulcers of the left hip are the most severe classification, with full-thickness tissue loss exposing bone, tendon, muscle, or joint capsule. These wounds carry extreme risk for osteomyelitis of the femur, septic arthritis of the hip joint, and systemic infection. They require intensive multidisciplinary management and often surgical reconstruction.
Documentation Requirements
- ✓Anatomical location specified as left hip
- ✓Stage explicitly documented as stage 4
- ✓Specific deep structures exposed (bone, muscle, tendon, joint capsule)
- ✓Complete wound measurements
- ✓Undermining and tunneling extent
- ✓Imaging for osteomyelitis (MRI, bone scan)
- ✓Wound and bone cultures
- ✓Nutritional labs
- ✓Surgical consultation documentation
- ✓Comprehensive treatment plan