L89.303
BillablePressure ulcer of unspecified buttock, stage 3
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is L89.303 an HCC code?
Yes. L89.303 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 L89.303
For L89.303 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 L89.303 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
L89.303 is the ICD-10-CM diagnosis code for pressure ulcer of unspecified buttock, stage 3. A stage 3 pressure ulcer on an unspecified buttock, involving full-thickness skin loss extending into subcutaneous tissue without exposing bone or muscle. L89.303 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, L89.303 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, L89.303 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.
Clarify laterality (left or right buttock) in documentation when available to allow for more specific coding. Because L89.303 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 L89.303 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Clarify laterality (left or right buttock) in documentation when available to allow for more specific coding
- •Document depth, presence of undermining, and any necrotic tissue; stage 3 requires full-thickness involvement
Clinical Significance
Stage 3 pressure ulcers of the unspecified buttock involve full-thickness skin loss extending into subcutaneous tissue. The buttock has relatively thick soft tissue, but stage 3 wounds here still represent significant morbidity. These wounds are common in patients with prolonged sitting or immobility and require specialized wound care, nutritional optimization, and pressure redistribution strategies.
Documentation Requirements
- ✓Anatomical location specified as buttock (query for laterality)
- ✓Stage explicitly documented as stage 3
- ✓Complete wound dimensions including depth
- ✓Wound bed characteristics
- ✓Undermining or tunneling documentation
- ✓Drainage assessment
- ✓Infection signs
- ✓Wound care plan
- ✓Nutritional assessment