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L89.216 ICD-10-CM Code: Pressure-induced deep tissue damage of right hip

Compare with another codeCheck this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
5 inclusion terms · 5 Excludes2 · 1 code-first instruction

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Code firstSequence the underlying condition before this code
  • any associated gangrene (I96)
Excludes2Not included here; may be reported together

+1 more in Instructions

IncludesWhat this code covers
  • bed sore
  • decubitus ulcer
  • plaster ulcer
  • pressure area

+1 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 573 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC (MDC 09)
  • MS-DRG 574 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC (MDC 09)
  • MS-DRG 575 — SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC (MDC 09)
  • MS-DRG 592 — SKIN ULCERS WITH MCC (MDC 09)
  • MS-DRG 593 — SKIN ULCERS WITH CC (MDC 09)
  • MS-DRG 594 — SKIN ULCERS WITHOUT CC/MCC (MDC 09)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for L89.216 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on L89.216 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • bed sore
  • decubitus ulcer
  • plaster ulcer
  • pressure area
  • pressure sore

Source: inherited from L89

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from L89

Code First

Underlying conditions that must be sequenced before this code.

  • any associated gangrene (I96)

Source: inherited from L89

Coder workflow for L89.216

MedCoder structured workflow — derived from this code’s own official record

Before you code L89.216

  1. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: right). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

Choose the right path

  1. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then L89.216.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewI96

  2. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

Consider L89.216. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Stage
The documented stage decides the sibling code; where a Use Additional Code note asks for a stage code, report it as well.
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes2 — not part of L89.216(5 notes)

    Coding workflow: The conditions named in this note are not included in L89.216. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareN86, E08.621, E08.622, E09.621, E09.622, E10.621

    See the official tabular notes · Guidelines I.A.12.b

  • Code First — sequencing check(1 note)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before L89.216. Do not add an underlying condition the record does not document.

    ReviewI96

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewI96

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse L89.216 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of L89.216 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • L89.219— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Pressure ulcer of right hip, unspecified stage” takes L89.219; specificity in the record moves it back here.

    Full comparison: L89.216 vs L89.219 →

  • L89.226— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A documented left side moves the case to L89.226.

    Full comparison: L89.216 vs L89.226 →

  • L89.206— Laterality relationship (Review)

    Same condition; these differ only in which side is documented.

    The same condition on the other side; the documented side decides, and a bilateral code, where one exists, replaces the pair when both sides are documented.

    What moves you there: A record that states no side takes L89.206; a documented side moves it back to a sided code.

    Full comparison: L89.216 vs L89.206 →

  • N86— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of decubitus (trophic) ulcer of cervix (uteri) adds N86; it is not part of this code and both may be reported when both are documented.

    Full comparison: L89.216 vs N86 →

  • E08.621— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of diabetic ulcers adds E08.621; it is not part of this code and both may be reported when both are documented.

    Full comparison: L89.216 vs E08.621 →

  • E08.622— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of diabetic ulcers adds E08.622; it is not part of this code and both may be reported when both are documented.

    Full comparison: L89.216 vs E08.622 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Pressure-induced deep tissue damage of right hip is a billable ICD-10-CM diagnosis code (L89.216).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

1) Pressure ulcer stages Codes in category L89, Pressure ulcer, identify the site and stage of the pressure ulcer.

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

Assign as many codes from category L89 as needed to identify all the pressure ulcers the patient has, if applicable.

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

2) Unstageable pressure ulcers Assignment of the code for unstageable pressure ulcer (L89.--0) should be based on the clinical documentation. These codes are used for

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

pressure ulcers whose stage cannot be clinically determined (e.g., the ulcer is covered by eschar or has been treated with a skin or muscle graft). This code should not be confused with the codes for unspecified stage (L89.--9). When there is no documentation regarding the stage of the pressure ulcer, assign the appropriate code for unspecified stage (L89.-- 9).

Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)

7) Pressure-induced deep tissue damage For pressure-induced deep tissue damage or deep tissue pressure injury, assign only the appropriate code for pressure-induced deep tissue damage (L89.--6).

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. Laterality is coded in this family. Confirm the documented side matches the code — the opposite-side siblings are in the relationships section. See the opposite-side sibling codes
  2. Sequencing: 1 Code First instruction — the underlying condition is sequenced before this code when present. See the Code First notes
  3. 5 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name L89.216 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 4 Excludes2 notes across 2 chapters: L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified (via L89.-), L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified (via L89.-), L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified (via L89.-), M70 — Soft tissue disorders related to use, overuse and pressure (via L89.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Use Additional Code instruction: G90.4 — Autonomic dysreflexia (via L89.-).

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 6 MS-DRGs: DRG 573 (MDC 09), DRG 574 (MDC 09), DRG 575 (MDC 09), DRG 592 (MDC 09), DRG 593 (MDC 09), DRG 594 (MDC 09).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):SKN003 — Pressure ulcer of skin (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same condition, opposite side

Same category and title, differing only in which side of the body is affected.

L89.206 — Pressure-induced deep tissue damage of unspecified hip (unspecified)Compare L89.216 vs L89.206 →, L89.226 — Pressure-induced deep tissue damage of left hip (left)Compare L89.216 vs L89.226 →

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Pressure ulcer of skin).

L89.202 — Pressure ulcer of unspecified hip, stage 2, L89.203 — Pressure ulcer of unspecified hip, stage 3, L89.204 — Pressure ulcer of unspecified hip, stage 4, L89.206 — Pressure-induced deep tissue damage of unspecified hip, L89.209 — Pressure ulcer of unspecified hip, unspecified stage, L89.210 — Pressure ulcer of right hip, unstageable, L89.211 — Pressure ulcer of right hip, stage 1, L89.212 — Pressure ulcer of right hip, stage 2, L89.213 — Pressure ulcer of right hip, stage 3, L89.214 — Pressure ulcer of right hip, stage 4, L89.219 — Pressure ulcer of right hip, unspecified stage, L89.220 — Pressure ulcer of left hip, unstageable, L89.221 — Pressure ulcer of left hip, stage 1, L89.222 — Pressure ulcer of left hip, stage 2, L89.223 — Pressure ulcer of left hip, stage 3, L89.224 — Pressure ulcer of left hip, stage 4, L89.226 — Pressure-induced deep tissue damage of left hip, L89.229 — Pressure ulcer of left hip, unspecified stage, L89.300 — Pressure ulcer of unspecified buttock, unstageable, L89.301 — Pressure ulcer of unspecified buttock, stage 1, +164 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HbA1c Test (Glycated Hemoglobin), Blood Glucose Test

Contextual Map

Every relationship of L89.216 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run L89.216 with these 5 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions

  • G90.4 — Autonomic dysreflexia[Use Additional Code](via L89.-): “pressure ulcer (pressure area) (L89.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 09 — Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast[MDC crossing]: “Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 7,378 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Nearest codes (40)

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "L89.216 — Pressure-induced deep tissue damage of right hip." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/l89.216-pressure-induced-deep-tissue-damage-of-right-hip

Change history

  • FY2020 — October 1, 2019
    Added to the code set
    Pressure-induced deep tissue damage of right hip
    FY2020 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to L89.216 in its code family, with their registry titles.

View all codes in the L89 family