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L89.302

Billable

Pressure ulcer of unspecified buttock, stage 2

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

Is L89.302 an HCC code?

Yes. L89.302 maps to Pressure Ulcer of Skin with Partial Thickness Skin Loss under the CMS-HCC V28 risk adjustment model (and Pressure Ulcer of Skin with Partial Thickness Skin Loss under V24).

HCC Category Mapping

V28HCC 382Pressure Ulcer of Skin with Partial Thickness Skin Loss
0.000
V24HCC 159Pressure Ulcer of Skin with Partial Thickness Skin Loss
0.000
ESRDHCC 159Pressure Ulcer of Skin with Partial Thickness Skin Loss
0.000

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 L89.302

For L89.302 to 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 L89.302 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

L89.302 is the ICD-10-CM diagnosis code for pressure ulcer of unspecified buttock, stage 2. A stage 2 pressure ulcer on an unspecified buttock, involving partial thickness skin loss with exposure of the dermis. L89.302 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, L89.302 maps to Pressure Ulcer of Skin with Partial Thickness Skin Loss (HCC 382) with a community, non-dual, aged base RAF weight of 0.000. The V24 model used during the PY2024–PY2025 transition mapped L89.302 the same way and at the same RAF weight. 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.

Document which buttock is affected when possible to allow for more specific coding; if truly unspecified, this code is appropriate. Because L89.302 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 L89.302 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document which buttock is affected when possible to allow for more specific coding; if truly unspecified, this code is appropriate
  • Stage 2 may present as a blister, abrasion, or shallow crater; document the clinical presentation

Clinical Significance

Stage 2 pressure ulcers of the unspecified buttock represent partial-thickness skin loss at a common pressure site. The buttock is a primary weight-bearing surface in seated patients, making these ulcers particularly relevant in wheelchair-bound populations. While early-stage, they indicate failed prevention strategies and require immediate intervention to prevent progression.

Documentation Requirements

  • Anatomical location specified as buttock (query for laterality)
  • Stage explicitly documented as stage 2
  • Wound appearance and measurements
  • Surrounding skin condition
  • Seating surface evaluation for wheelchair users
  • Moisture management plan
  • Prevention and treatment interventions

Commonly Confused Codes

  • L89.312 — Stage 2 right buttock; use when right side is documented
  • L89.322 — Stage 2 left buttock; use when left side is documented
  • L89.152 — Stage 2 sacral region; different anatomical site
  • L89.301 — Stage 1 unspecified buttock; intact skin with erythema only

Code Hierarchy

More on L89.302

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