L89.524
Pressure ulcer of left ankle, stage 4
L89.524 (also written L89524) is a billable ICD-10-CM diagnosis code for pressure ulcer of left ankle, stage 4. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 175 codes in category L89 (Pressure ulcer). Its coding notes include a Code first instruction and 15 Excludes2 entries.
Guidelines tips
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
Each pressure ulcer gets its own L89 code for site and stage. A healing ulcer is coded to its documented stage, and deep tissue injury has its own stage code.
Pressure ulcer stage, ulcer depth, BMI, NIHSS and coma scale may be coded from other clinicians' documentation. The diagnosis itself must be documented by the patient's provider.
Unstageable and unspecified stage are different codes. A completely healed ulcer at admission is not coded. If the stage progresses during an inpatient stay, two codes are assigned for the same site.
Code first
If the underlying condition listed here is present and known, sequence it first.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- lipomelanotic reticulosis (I89.8)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- viral warts (B07.-)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Wound clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital MCC
Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 479 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CHAC
On the CMS list of hospital-acquired conditions (HAC 04: Stage III and IV Pressure Ulcers). When the claim reports it with a present-on-admission (POA) indicator of N (not present) or U (documentation insufficient), CMS does not pay the CC or MCC DRG for it. A POA of Y (present) or W (clinically undetermined) is paid normally.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix I; CMS Hospital-Acquired Conditions (HAC) Coding page, POA indicator payment tableIncludes
Further defines or gives examples of the content of the category.
- bed sore
- decubitus ulcer
- plaster ulcer
- pressure area
- pressure sore
Inclusion terms
Conditions classified to this code.
- Healing pressure ulcer of left ankle, stage 4
- Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, left ankle