Deep Tissue Injury
The ICD-10-CM updates effective October 1, 2019 will contain 273 new codes. One notable addition is the expansion of category L89 Pressure ulcer to include specific codes for Deep Tissue Pressure Injury. Prior to this change, DTPI was coded as an unstageable pressure injury. As discussed in ICD-10 Coordination and Maintenance Committee Meeting in September 2018 the clinical differences between unstageable ulcers and deep tissue injuries can be signification as detailed in the excerpt from the minutes.
“Deep tissue injury is currently indexed to “ulcer, pressure, unstageable, by site.” However, unstageable ulcers can ONLY be Stage 3 or 4, by definition (“full-thickness skin and tissue loss in which the extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar. If slough or eschar is removed, a Stage 3 or Stage 4 pressure injury will be revealed”). By contrast, deep tissue injury may resolve without tissue loss. In addition, deep tissue injuries often have a combined etiology involving both ischemia and pressure. AHRQ is requesting the following new codes to identify and track these conditions for surveillance and quality improvement purposes.”
A new ICD-10-CM guideline was also added to address correct reporting of deep tissue pressure injuries.
I.C.12.a.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).
A list of the new codes is provided below. In preparation for the new codes communicate and educate affected intra and extra departmental staff. Examining how your encoder will be updated to handle these new codes should also be performed before October 1st.
NEW CODES:
L89006 Pressure-induced deep tissue
damage of unspecified elbow
L89016
Pressure-induced deep tissue damage of right
elbow
L89026
Pressure-induced deep tissue damage of
left
L89106 Pressure-induced
deep tissue damage of unspecified part of back
L89116
Pressure-induced deep tissue damage of right upper
back
L89126
Pressure-induced deep tissue damage of left upper
back
L89136
Pressure-induced deep tissue damage of right lower
back
L89146
Pressure-induced deep tissue damage of left lower
back
L89156
Pressure-induced deep tissue damage of sacral
region
L89206
Pressure-induced deep tissue damage of unspecified
hip
L89216
Pressure-induced deep tissue damage of right hip
L89226
Pressure-induced deep tissue damage of left
L89306
Pressure-induced deep tissue damage of unspecified buttock
L89316
Pressure-induced deep tissue damage of right
buttock
L89326
Pressure-induced deep tissue damage of left
buttock
L8946
Pressure-induced deep tissue damage of contiguous site of back, buttock and hip
L89506
Pressure-induced deep tissue damage of unspecified
ankle
L89516
Pressure-induced deep tissue damage of right ankle
L89526 Pressure-induced
deep tissue damage of left
ankle
L89606
Pressure-induced deep tissue damage of unspecified
heel
L89616
Pressure-induced deep tissue damage of right
heel
L89626
Pressure-induced deep tissue damage of left
heel
L89816
Pressure-induced deep tissue damage of
head
L89896 Pressure-induced
deep tissue damage of other
site
L8996
Pressure-induced deep tissue damage of unspecified site