Decubitus (pressure) ulcer, Stage III (deep, to but not including muscle)

ICD10 Diagnosis
Dx:	Decubitus (pressure) ulcer, Stage III (deep, to but not including muscle)
ICD10 code:	L89.2
Pre-ICD10 counterpart:	Ulcers - Decubitus only
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	none
Start Date:
Stop Date:
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

• SMW
  • 2019-01-01
  • 2999-12-31
  • L89.2

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Additional Info

Pressure Ulcer on Wikipedia

• Stage 3 - Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed.
• If there are pressure ulcers on DIFFERENT body parts (e.g. left heel, right heel, coccyx) then code them separately -- even though they will not be readily distinguishable as the code doesn't include body location.
• If there are multiple pressure ulcers close to each other on the same body part (e.g. coccyx area) then only code the one of the highest/worst stage.

Coding multiple ulcers

• If there are pressure ulcers on DIFFERENT body parts (e.g. left heel, right heel, coccyx) then code them separately -- even though they will not be readily distinguishable as the code doesn't include body location.

• If there are multiple pressure ulcers close to each other on the same body part (e.g. coccyx area) then only code the one of the highest/worst stage.

Coding Progression of Ulcers

• Progression of Ulcers should be coded following our guidelines for Acquired Diagnosis combine each stage progression with the date and time it was noted in the chart.

If there are multiple pressure ulcers follow the above guidelines -- even though they will not be readily distinguishable as the code doesn't include body location.

• Julie will report on the worst stage from Acquired Diagnosis

• NOTE: As per our TASK meeting , there was a significant rise in the number of acquired stage 1 and 2 decubitus ulcers at the GGH ICU, beginning Jan 2022.

A sample of charts from the timeframe of concern was audited, and we collaborated with the GGH educator and manager and we were unable to determine a reason for this rise. Going forward, a recommendation will be forwarded to the OIT committee, and education about proper documentation of stages of decubitus ulcers will be reinforced across all sites. This will begin in March 2024. Up until March 2024 the data re. acquired decubitus ulcers is not reliable, as it often required the collector to subjectively interpret documentation on the stage of the decubitus ulcer.

Coding Necrotic Ulcers

• This code should be used for necrotic decubitus pressure ulcers

Alternate ICD10s to consider coding instead or in addition

Decubitus ulcer codes:

Decubitus (pressure) ulcer, Stage I (surface reddening) Decubitus (pressure) ulcer, Stage II (to fascia, just under skin) Decubitus (pressure) ulcer, Stage IV (involves muscle, tendon, or bone) Decubitus (pressure) ulcer, stage not indicated

Or:

• Ulcers - Diabetic foot only
• Skin ulcer, NOS

Candidate Combined ICD10 codes

Related CCI Codes

• code Debridement if applicable

Data Integrity Checks (automatic list)

none found

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Misc Adverse effect Alcohol related Allergy Anesthetic related Antidepressant related Awaiting/delayed transfer COVID Cannabis related Cocaine related Decubitus ulcer Diagnosis implying death Exposure Fistula Hallucinogen related Has one Healthcare contact Hemorrhage Iatrogenic Metabolic/nutrition Non-traumatic fracture Observation Organ removal Ostomy Overdose Paralysis Past medical history Poisoning Psychoactive substance NOS related Radiation related Retired Code Rheumatic disease Sedative related Shock Solvent related Spine Stimulant related Transplant	Reproductive Abortion Breast disease Female genital neoplasm Male genital neoplasm Peripartum	Gastrointestinal Cirrhosis GI ulcer Gastroenteritis Gastrointestinal neoplasm Hepatitis Hernia Inflammatory Bowel Disease Intra-abdominal infection Ischemic gut Liver disease Liver failure Pancreas disease Pancreatitis Peptic ulcer	Musculoskeletal/soft tissue Hernia Joint/ligament trauma Muscle problem Muscles/tendon trauma Musculoskeletal/soft tissue neoplasm Osteomyelitis
Psych Addiction Antidepressant related Delirium Dementia Hallucinogen related Opioid related Psychoactive substance NOS related Sedative related Solvent related Stimulant related Withdrawal	Respiratory Asthma Influenza Inhalation Lower respiratory tract infection Pleural abnormalities Pneumoconiosis Pneumonia Pneumothorax Pulmonary embolism Respiratory neoplasm Sleep disorder Tracheostomy Upper respiratory tract infection	Poisoning Acute intoxication Addiction Opioid related Overdose Poisoning by non-pharmaceuticals Stimulant related Withdrawal
Neuro Cerebral Hemorrhage/Stroke Encephalitis Encephalopathy Meningitis Neuro neoplasm Paralysis	Symptom/Sign Pain	Endocrine disorder Adrenal Insufficiency Diabetes Endocrine neoplasm Metabolic/nutrition

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