ICD-10 L89.212
Billable / Specific HCC v28: 159Pressure ulcer of right hip, stage 2
About ICD-10-CM L89.212
ICD-10-CM code L89.212 represents Pressure ulcer of right hip, stage 2. This is a billable/specific code in the Skin and Subcutaneous Tissue chapter (block L89). The 2026 edition of ICD-10-CM L89.212 became effective on October 1, 2025.
Coding Tips for L89.212
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
L89.212 is a CMS-HCC v28 risk-adjustment code (category 159). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under L89.212. Per CMS ICD-10-CM Tabular 2026.
- Healing pressure ulcer of right hip, stage 2
- Pressure ulcer with abrasion, blister, partial thickness skin loss involving epidermis and/or dermis, right hip
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for L89.212
Local Coverage Determinations (LCDs) from CMS MACs that list L89.212 as a covered diagnosis.
Showing top 10 of 390 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing L89.212.
5 Medicare
1 NY Medicaid
CPT Codes Commonly Billed with L89.212
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert L89.212 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| L89.212 | 70704 | 10111 |
| L89.212 | 70722 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To L89.212
Other codes in section L80-L99 (Other disorders of the skin and subcutaneous tissue).
ICD-10 L89.212, Billing FAQ
Is ICD-10 code L89.212 billable? +
Yes, L89.212 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to L89.212? +
ICD-10 L89.212 includes: Healing pressure ulcer of right hip, stage 2; Pressure ulcer with abrasion, blister, partial thickness skin loss involving epidermis and/or dermis, right hip.
Does L89.212 affect Medicare Advantage HCC risk adjustment? +
Yes. L89.212 maps to CMS-HCC v28 category 159. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does L89.212 map to? +
Per CMS GEMs, L89.212 maps to ICD-9 codes: 70704, 70722. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team