What is ICD-10 code L89.523?

L89.523 is the ICD-10-CM diagnosis code for Pressure ulcer of left ankle, stage 3. A stage 3 pressure ulcer on the left ankle where the wound extends through the skin into the underlying tissue, but does not expose bone or muscle. L89.523 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. L89.523 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. L89.523 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. L89.523 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for L89.523?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For L89.523, V28 maps to Pressure Ulcer of Skin, Unstageable/Unspecified at RAF 0.000 while V24 mapped to Pressure Ulcer of Skin with Full Thickness Skin Loss at RAF 0.662. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting L89.523?

Stage 3 represents full-thickness skin loss; verify documentation confirms depth extends into subcutaneous tissue without bone/muscle exposure Distinguish from stage 4 by confirming absence of exposed bone, tendon, or muscle in clinical notes Because L89.523 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

L89.523 ICD-10 Code: Pressure ulcer of left ankle

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupL89.523Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the skin and subcutaneous tissue (L00-L99) / Other disorders of the skin and subcutaneous tissue (L80-L99)

L89.523

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Pressure ulcer of left ankle, stage 3

A stage 3 pressure ulcer on the left ankle where the wound extends through the skin into the underlying tissue, but does not expose bone or muscle.

Buddy Insight

A stage 3 pressure ulcer of the left ankle represents full thickness skin loss where subcutaneous fat may be visible but bone, tendon, and muscle are not exposed.

CMS-HCC V28

Mapped

HCC 381

Pressure Ulcer of Skin, Unsta...

RAF 0.0

CMS-HCC V24

Mapped

HCC 158

Pressure Ulcer of Skin with F...

RAF 0.662

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 158

Pressure Ulcer of Skin with F...

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

L89.5Pressure ulcer of ankle

L89.52Pressure ulcer of left ankle

L89.523Pressure ulcer of left ankle, stage 3

Inclusion Terms

Official

Healing pressure ulcer of left ankle, stage 3
Pressure ulcer with full thickness skin loss involving damage or necrosis of subcutaneous tissue, left ankle

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for L89.523 in this effective period.

Related Child Codes

Official

L89.520Pressure ulcer of left ankle, unstageable

L89.521Pressure ulcer of left ankle, stage 1

L89.522Pressure ulcer of left ankle, stage 2

L89.524Pressure ulcer of left ankle, stage 4

L89.526Pressure-induced deep tissue damage of left ankle

Includes

Official

ICD-10-CM does not list Includes notes for L89.523 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for L89.523 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for L89.523 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for L89.523 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for L89.523 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Exact anatomical location of the pressure ulcer with laterality

Explicit staging as stage 3 by the treating provider

Wound bed description including presence of granulation tissue, slough, or undermining

Wound dimensions: length x width x depth in centimeters

MEAT Support

HCC Buddy guidance

Exact anatomical location of the pressure ulcer with laterality

Explicit staging as stage 3 by the treating provider

Wound bed description including presence of granulation tissue, slough, or undermining

Wound dimensions: length x width x depth in centimeters

Audit Caution

HCC Buddy guidance

Do not assign stage 3 if bone, muscle, or tendon is visible — that is stage 4

Stage 3 depth varies by anatomical location; areas with minimal subcutaneous tissue (nose, ear, occiput, ankle) can appear shallow but still be stage 3

If slough prevents full visualization of the wound bed, consider unstageable rather than assuming stage 3

Never reverse-stage a healing ulcer — a healing stage 3 remains stage 3, not stage 2

Common Mistakes

HCC Buddy guidance

L89.524 — Stage 4 of left ankle has exposed bone, tendon, or muscle; stage 3 does not

L89.520 — Unstageable of left ankle means wound bed is obscured by slough or eschar

L89.522 — Stage 2 of left ankle is partial thickness only (dermis exposed); stage 3 extends into subcutaneous tissue

L97.xxx — Non-pressure chronic ulcers have different etiology and separate code category

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 L89.523 an HCC code?

Yes. L89.523 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

V28HCC 381, Pressure Ulcer of Skin, Unstageable/Unspecified

0.000

V24HCC 158, Pressure Ulcer of Skin with Full Thickness Skin Loss

0.662

ESRDHCC 158, Pressure Ulcer of Skin with Full 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 L89.523

For L89.523to 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 L89.523 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

L89.523 is the ICD-10-CM diagnosis code for pressure ulcer of left ankle, stage 3. A stage 3 pressure ulcer on the left ankle where the wound extends through the skin into the underlying tissue, but does not expose bone or muscle. L89.523 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, L89.523 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, L89.523 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; verify documentation confirms depth extends into subcutaneous tissue without bone/muscle exposure. Because L89.523 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 L89.523 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; verify documentation confirms depth extends into subcutaneous tissue without bone/muscle exposure
•Distinguish from stage 4 by confirming absence of exposed bone, tendon, or muscle in clinical notes

Clinical Significance

A stage 3 pressure ulcer of the left ankle represents full thickness skin loss where subcutaneous fat may be visible but bone, tendon, and muscle are not exposed. This stage indicates significant tissue destruction requiring aggressive wound management, nutritional optimization, and pressure redistribution strategies. Stage 3 pressure ulcers carry substantial risk adjustment weight under V24 (HCC 158, RAF 0.662) reflecting the high clinical complexity and resource demands of managing deep wound healing.

Documentation Requirements

✓Exact anatomical location of the pressure ulcer with laterality
✓Explicit staging as stage 3 by the treating provider
✓Wound bed description including presence of granulation tissue, slough, or undermining
✓Wound dimensions: length x width x depth in centimeters
✓Presence or absence of tunneling, undermining, or sinus tracts with measurements
✓Description of wound edges (rolled, attached, unattached)
✓Wound drainage characteristics (type, amount, color, odor)
✓Current wound care plan (debridement, dressings, negative pressure wound therapy, etc.)
✓Nutritional status and support measures
✓Underlying etiology and contributing factors (immobility, incontinence, vascular disease)

Commonly Confused Codes

•L89.524: Stage 4 of left ankle has exposed bone, tendon, or muscle; stage 3 does not
•L89.520: Unstageable of left ankle means wound bed is obscured by slough or eschar
•L89.522: Stage 2 of left ankle is partial thickness only (dermis exposed); stage 3 extends into subcutaneous tissue
•L97.xxx: Non-pressure chronic ulcers have different etiology and separate code category