L89.603
BillablePressure ulcer of unspecified heel, stage 3
HCC Category Mapping
V28HCC 381 — Pressure Ulcer of Skin, Unstageable/Unspecified
0.000V24HCC 158 — Pressure Ulcer of Skin with Full Thickness Skin Loss
0.662ESRDHCC 158 — Pressure Ulcer of Skin with Full Thickness Skin Loss
0.000What This Code Means
A stage 3 pressure ulcer on the heel extending through the full thickness of skin into the underlying fatty tissue, but without exposing bone or muscle.
Coding Tips
- •Stage 3 indicates full-thickness skin loss with subcutaneous tissue involvement; verify bone/muscle are not visible
- •Document wound depth, width, and any tunneling or undermining in the clinical record for comprehensive assessment
Clinical Significance
A stage 3 pressure ulcer of the unspecified heel 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
L89.604 — Stage 4 of unspecified heel has exposed bone, tendon, or muscle; stage 3 does notL89.600 — Unstageable of unspecified heel means wound bed is obscured by slough or escharL89.602 — Stage 2 of unspecified heel is partial thickness only (dermis exposed); stage 3 extends into subcutaneous tissueL97.xxx — Non-pressure chronic ulcers have different etiology and separate code category
Code Hierarchy
└L89Pressure ulcer└L89.6Pressure ulcer of heel└L89.60Pressure ulcer of unspecified heel└L89.603Pressure ulcer of unspecified heel, stage 3
└L89.603Pressure ulcer of unspecified heel, stage 3