L89.324

Billable

Pressure ulcer of left buttock, stage 4

HCC Category Mapping

V28HCC 379 — Pressure Ulcer of Skin with Full Thickness Skin Loss

0.662

V24HCC 157 — Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone

1.071

ESRDHCC 157 — Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone

0.000

What This Code Means

A stage 4 pressure sore on the left buttock involving full-thickness skin loss with exposure of underlying bone, tendon, or muscle.

Coding Tips

•Stage 4 is the most severe; document the extent of tissue involvement and any exposed anatomical structures
•Ensure clinical documentation explicitly confirms exposure of bone, tendon, or muscle to justify this stage

Clinical Significance

Stage 4 pressure ulcers of the left buttock represent the most severe wound classification with exposed bone, muscle, or tendon. These devastating wounds carry high risk for ischial osteomyelitis, deep space infection, and sepsis. They frequently require surgical intervention and represent the highest level of patient complexity among pressure ulcer diagnoses.

Documentation Requirements

✓Anatomical location specified as left buttock
✓Stage explicitly documented as stage 4
✓Specific exposed structures identified
✓Complete wound measurements
✓Undermining and tunneling extent
✓Osteomyelitis evaluation (imaging, biopsy)
✓Wound cultures
✓Nutritional labs
✓Surgical consultation documentation
✓Comprehensive wound management plan

Commonly Confused Codes

L89.323 — Stage 3 left buttock; NO deep structure exposure L89.320 — Unstageable left buttock; wound bed obscured L89.314 — Stage 4 right buttock; laterality difference L89.224 — Stage 4 left hip; different anatomical site

Code Hierarchy

└L89Pressure ulcer └L89.3Pressure ulcer of buttock └L89.32Pressure ulcer of left buttock └L89.324Pressure ulcer of left buttock, stage 4

└L89.324Pressure ulcer of left buttock, stage 4