Group 1 Codes:
A4640 REPLACEMENT PAD FOR USE WITH MEDICALLY NECESSARY ALTERNATING PRESSURE PAD OWNED BY PATIENT
A9270 NON-COVERED ITEM OR SERVICE
E0181 POWERED PRESSURE REDUCING MATTRESS OVERLAY/PAD, ALTERNATING, WITH PUMP, INCLUDES HEAVY DUTY
E0182 PUMP FOR ALTERNATING PRESSURE PAD, FOR REPLACEMENT ONLY
E0184 DRY PRESSURE MATTRESS
E0185 GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
E0186 AIR PRESSURE MATTRESS
E0187 WATER PRESSURE MATTRESS
E0188 SYNTHETIC SHEEPSKIN PAD
E0189 LAMBSWOOL SHEEPSKIN PAD, ANY SIZE
E0196 GEL PRESSURE MATTRESS
E0197 AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
E0198 WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
E0199 DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
E1399 DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS
Clarification on Use of A9270
HCPCS code A9270, Non-covered item or service, will remain an active code and valid for Medicare. A processing note will be added to the HCPCS file that states, “Only for use on bills submitted by DMEPOS suppliers.”
Use of the GA, GY, and GZ Modifiers for Services Billed to Carriers
The new GY modifier must be used when physicians, practitioners, or suppliers want to indicate that the item or service is statutorily non-covered (as defined in the Program Integrity Manual (PIM) Chapter 1, §2.3.3.B) or is not a Medicare benefit (as defined in the PIM, Chapter 1, §2.3.3.A). The new GZ modifier must be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny an item or service as not reasonable and necessary and they have not had an Advance Beneficiary Notification (ABN) signed by the beneficiary. The GA modifier must be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny a service as not reasonable and necessary and they do have on file an ABN signed by the beneficiary
The GY and GZ modifiers should be used with the specific, appropriate HCPCS code when one is available. In cases where there is no specific procedure code to describe services, a “not otherwise classified code” (NOC) must be used with either the GY or GZ modifier. The A9270 will no longer be accepted for services or items billed to carriers. Use of the GA, GY, and GZ Modifiers for Items and Supplies Billed to DMERCs The new GY modifier must be used when suppliers want to indicate that the item or supply is statutorily non-covered (as defined in the Program Integrity Manual (PIM) Chapter 1, §2.3.3.B) or is not a Medicare benefit (as defined in the PIM, Chapter 1, §2.3.3.A). The new GZ modifier must be used when suppliers want to indicate that they expect that Medicare will deny an item or supply as not reasonable and necessary and they have not had an Advance Beneficiary Notification (ABN) signed by the beneficiary. The GA modifier must be used when suppliers want to indicate that they expect that Medicare will deny an item or supply as not reasonable and necessary and they do have on file an ABN signed by the beneficiary.
The GY and GZ modifiers should be used with the specific, appropriate HCPCS code when one is available. In cases where there is no specific procedure code to describe items or supplies, a NOC must be used with either the GY or GZ modifiers.
In cases where there is no specific procedure code for an item or supply and no appropriate NOC code available, the HCPCS code A9270 must be used by suppliers to bill for statutorily non-covered items and items that do not meet the definition of a Medicare benefit.
Elevating/stair climbing power wheelchairs are class III devices. The DMERCs have been instructed in transmittal 35, dated December 24, 2003, that claims for the base power wheelchair portion of this device are to be billed using HCPCS code K0011 (programmable power wheelchair base) with modifier KF for claims received on or after April 1, 2004, with dates of service on or after January 1, 2004. For claims with dates of service on or after January 1, 2004, the elevation feature for this device should be billed using HCPCS code E2300 and the stair climbing feature for this device should be billed using HCPCS code A9270.
Regional Home Health Intermediaries (RHHIs) will not be able to implement the KF modifier until January 1, 2005. Therefore, for claims with dates of service prior to January 1, 2005, RHHIs should advise their HHAs that claims for the base power wheelchair portion of stair climbing wheelchairs must be submitted with HCPCS code E1399. The fee schedule amounts for K0011 with and without the KF modifier appear on the fee schedule file referenced at ww.cms.hhs.gov/providers/pufdownload/default.asp#dme. For claims with dates of service prior to January 1, 2005, RHHIs should pay claims for stair climbing wheelchair bases billed with code E1399 using the fee schedule amounts for K0011 with the KF modifier. All other claims for programmable power wheelchair bases should be paid using the fee schedule amounts for K0011 without the KF modifier.
Effective for claims with dates of service on or after January 1, 2005, HHAs must submit modifier KF along with the applicable HCPCS code for all DME items classified by the FDA as class III devices.
Coverage Guidance
Coverage Indications, Limitations, and/or Medical Necessity
For any item to be covered by Medicare, it must: 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this local coverage determination, the criteria for "reasonable and necessary", based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity.
Medicare does not automatically assume payment for a durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) item that was covered prior to a beneficiary becoming eligible for the Medicare Fee For Service (FFS) program. When a beneficiary receiving a DMEPOS item from another payer (including Medicare Advantage plans) becomes eligible for the Medicare FFS program, Medicare will pay for continued use of the DMEPOS item only if all Medicare coverage, coding and documentation requirements are met. Additional documentation to support that the item is reasonable and necessary, may be required upon request of the DME MAC.
While this Standard Documentation language makes reference to “Affordable Care Act Section 6407 (ACA 6407) requirements”, technically these requirements are found in the Social Security Act Section 1843(a)(11)(B) and its implementing regulation at 42 CFR 410.38. The CMS regulation contains the details for the face-to-face examination, written order prior to delivery and the list of items subject to these requirements.
For an item to be covered by Medicare, a detailed written order (DWO) must be received by the supplier before a claim is submitted. If the supplier bills for an item addressed in this policy without first receiving the completed DWO, the item will be denied as not reasonable and necessary.
For some items in this policy to be covered by Medicare, a written order is required to be in the supplier’s file prior to delivery of the specified item(s). There are two differing order requirements that may apply depending upon the specific item prescribed:
The Affordable Care Act Section 6407 (ACA 6407) specifies the five elements that must be contained in this written order. For purposes of this policy, this order is termed the 5-element order (5EO).
A written order prior to delivery (WOPD) that meets all of the requirements of a standard detailed written order (DWO).
If the supplier delivers an item addressed in this policy without first receiving the completed order, the item will be denied. Refer to the DOCUMENTATION REQUIREMENTS section of this LCD and/or to the NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES section of the related Policy Article for information about these prescription requirements and the type of denial that will result from non-compliance.
A Group 1 mattress overlay or mattress (E0181-E0189, E0196-E0199, and A4640) is covered if one of the following three criteria are met:
The beneficiary is completely immobile - i.e., beneficiary cannot make changes in body position without assistance, or
The beneficiary has limited mobility - i.e., beneficiary cannot independently make changes in body position significant enough to alleviate pressure and at least one of conditions A-D below, or
The beneficiary has any stage pressure ulcer on the trunk or pelvis and at least one of conditions A-D below.
Conditions for criteria 2 and 3 (in each case the medical record must document the severity of the condition sufficiently to demonstrate the medical necessity for a pressure reducing support surface):
Impaired nutritional status
Fecal or urinary incontinence
Altered sensory perception
Compromised circulatory status
When the coverage criteria for a Group 1 mattress overlay or mattress are not met, the claim will be denied as not reasonable and necessary.
The support surface provided for the beneficiary should be one in which the beneficiary does not "bottom out". Bottoming out is the finding that an outstretched hand, placed palm up between the undersurface of the mattress overlay or mattress and the beneficiary's bony prominence (coccyx or lateral trochanter), can readily palpate the bony prominence. This bottoming out criterion should be tested with the beneficiary in the supine position with their head flat, in the supine position with their head slightly elevated (no more than 30 degrees), and in the side-lying position.
A support surface which does not meet the characteristics specified in the Coding Guidelines section of the Policy Article will be denied as not reasonable and necessary.
Bill Type Codes:
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
N/A
HCPCS MODIFIERS:
EY – No physician or other licensed health care provider order for this item or service
GA – Waiver of liability statement issued as required by payer policy, individual case
GZ – Item or service expected to be denied as not reasonable and necessary
KX - Requirements specified in the medical policy have been met
Usage of CPT E1399 - Medicare Guideliens
HCPCS code E1399 describes “durable medical equipment, miscellaneous” and is currently being used to bill for inexpensive DME subject to the rules of 42 C.F.R. 414.220, other covered DME subject to the rules of 42 C.F.R. 414.229, and replacement parts of DME subject to the rules of 42 C.F.R. 414.210(e). Likewise, HCPCS code K0108 describes a “wheelchair component or accessory, not otherwise specified” and is currently being used to bill for inexpensive DME subject to the rules of 42 C.F.R. 414.220, other covered DME subject to the rules of 42 C.F.R. 414.229, and replacement parts of wheelchairs subject to the rules of 42 C.F.R. 414.210(e). The rules of 42 C.F.R. 414.220 for inexpensive DME and the rules of 42 C.F.R. 414.229 for other covered DME mandate payment on the basis of fee schedule amounts, as noted above. Currently payment under codes E1399 and K0108 is not being made on the basis of fee schedule amounts, and the other rules of sections 414.220 and 414.229 are also not being applied to items billed using these codes.
In order to allow for accurate payment of Medicare claims for DME items subject to the rules of 42 C.F.R. 414.220 and 42 C.F.R. 414.229, and replacement parts for DME items subject to the rules of 42 C.F.R. 414.210(e), the edits to the HCPCS described We appreciate the comments received on the proposed coding changes below and will continue to consider the issue further. The changes described below will not take effect on January 1, 2016. Additional information will be provided on the status of these coding changes in the future. below will be made effective on January 1, 2016, for Medicare claims processing purposes.
The HCPCS codes E1399 and K0108 will be split into codes for:
a) inexpensive DME;
b) other DME or expensive DME; and c) replacement parts for DME being repaired.
The following HCPCS codes would replace codes E1399 and K0108, which will be made invalid for Medicare claims processing purposes:
1) KXXX1 Durable Medical Equipment, Miscellaneous, the Purchase Price Does Not Exceed $150
2) KXXX2 Durable Medical Equipment, Miscellaneous, the Purchase Price Exceeds $150
3) KXXX3 Wheelchair Component or Accessory, Miscellaneous, the Purchase Price Does not Exceed $150
4) KXXX4 Wheelchair Component or Accessory, Miscellaneous, the Purchase Price Exceeds $150
5) KXXX5 Repair Part For Use With Beneficiary Owned Durable Medical Equipment, Other Than Wheelchair, Not Covered Under Supplier Or Manufacturer Warranty, Not Otherwise Specified
6) KXXX6 Repair Part For Use With Beneficiary Owned Wheelchair, Not Covered Under Supplier Or Manufacturer Warranty, Not Otherwise Specified
Payment of covered items described by codes KXXX5 and KXXX6 will be made on a lump sum purchase basis in an amount that is based on the contractor’s individual
consideration of the item.
Codes KXXX1 and KXXX3 are to be used if the supplier’s actual charge for purchase of the item is $150 or less, or, for rental claims, if the supplier’s actual charge for rental of the item is $15 or less. If the supplier’s actual charge exceeds these thresholds, codes KXXX2 or KXXX4 should be used instead of these codes. Payment of covered items described by codes KXXX1 and KXXX3 will be made in accordance with the rules at 42 C.F.R. 414.220 for inexpensive items, with payment on a purchase or rental basis, and with total payments limited to the purchase fee schedule amount for the item. In establishing fee schedule amounts for these codes, the law mandates that the fee schedule amounts for inexpensive DME items be based on average reasonable charges for inexpensive DME items from July 1, 1986, through June 30, 1987. Since a range of various inexpensive DME items other than wheelchair accessories would fall under code KXXX1, the fee schedule amounts for this code will be based on the average reasonable charges for all inexpensive DME items other than wheelchair components or accessories from July 1, 1986, through June 30, 1987. The 2015 fee schedule amount generated based on this calculation is $97.94. This amount will be updated by the 2016 covered item update for use in paying claims with dates of service on or after January 1, 2016. Likewise, since a range of various inexpensive wheelchair components or accessories would fall under code KXXX3, the fee schedule amounts for this code will be based on the average reasonable charges for all inexpensive wheelchair components or accessories from July 1, 1986, through June 30, 1987. The 2015 fee schedule amount generated based on this calculation is $72.56. This amount will be updated by the 2016 covered item update for use in paying claims with dates of
service on or after January 1, 2016.
Durable medical equipment billing and reimbursement
Definitions
• Durable medical equipment (DME) is any equipment that provides therapeutic benefits to a member because of certain medical conditions and/or illnesses that can withstand repeated use, is primarily and customarily used to serve a medical purpose, and is appropriate for use in the home.
• Capped rentals – Durable medical equipment that a member uses continuously over a relatively short period of time, where rental is more appropriate than purchase, as determined by BCBSNC. Therefore, capped rental items are reimbursed by BCBSNC as rentals rather than as purchases. Capped rental payment includes all related costs for the effective use of the equipment by the member, including equipment, accessories, supplies, delivery, shipping and handling, labor, setup, visits, patient education, maintenance, repairs, and replacement parts of the DME item in question. Please note that in order for DME items to be eligible for reimbursement, the DME supplier must meet eligibility and/or credentialing requirements as defined by BCBSNC. . When DME is eligible for coverage, it is considered part of the member’s DME benefits provision.
Durable medical equipment billing requirements – General
• DME requires a prescription to rent or purchase, as applicable, before it is eligible for coverage.
• Certain items must be rented and may not be purchased (See “Capped Rentals”). Certain other items must be rented prior to being converted to a purchase in accordance with BCBSNC medical policy.
• Bill on a typed CMS-1500 (version 08/05) claim form.
• Bill the applicable modifier after all HCPCS codes (including, but not limited to NU, RR, etc).
• Bill maintenance and repair modifier codes first after the procedure code.
• Submit all claims for repairs with a complete description of services provided.
• Use E1399 or other miscellaneous HCPCS codes only if no suitable HCPCS billing code exists. Each claim with miscellaneous codes or custom items (i.e., foot orthotics, specialty wheelchairs) must include special documentation:
* Always submit a complete description of the item.
* With the initial claim, submit a factory invoice for the item (catalogs and retail price listings are not acceptable) and, if appropriate, a certificate of medical necessity form with the physician’s signature (See chapter 23, “Forms,” for appropriate form.).
* Do not staple this documentation to the claim form.
* Submit all initial claims on paper to ensure that the appropriate documentation is received in the same envelope.
* The additional documentation cannot be transmitted with electronically submitted claims.
Reimbursement – General
• Medical review documentation: All services that are not authorized in advance (i.e., certification number obtained) will be subject to medical review. The medical review process will be expedited, if your files include:
* Physician’s plan of treatment, including anticipated time frame that the equipment will be needed.
* Predicted outcomes (therapeutic benefit) as provided by the prescribing physician.
* Physician’s involvement in supervising the use of the prescribed item.
* Detailed description of the member’s clinical and functional status so that a determination of medical necessity can be made.
• DME requires a prescription to rent or purchase, as applicable, before it is eligible for coverage.
• Coverage will begin on the day the device is delivered, setup, and ready for use by the member at the location needed.
• Reimbursement for new or revised HCPCS codes will be reviewed and adjusted as pursuant to BCBSNC pricing policy. For example, if a new HCPCS code is reviewed and approved, it will automatically be added to the fee schedule (for specific details and instructions, please refer to your contract with BCBSNC and chapter 10 of this e-manual for the “Pricing Policy for Procedure/Service Codes”).
• The base reimbursement is inclusive of, and no additional reimbursement is payable for, fittings, shipping and handling, labor and subsequent adjustments to item.
o Manufacturer’s warranty – repairs and replacements should be addressed and paid through the manufacturer’s warranty before submitting claims to BCBSNC. Provider is responsible for billing BCBSNC only after the manufacturer’s warranty expires.
o DME may be purchased or rented at the discretion of BCBSNC.
Additional detail can be found in BCBSNC’s online Corporate Medical Policy for durable medical equipment at http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/durable_medical_equipment_(dme).pdf9.5
Coverage Indications, Limitations, and/or Medical Necessity - Group 2
For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this local coverage determination, the criteria for "reasonable and necessary", based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity.
Medicare does not automatically assume payment for a durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) item that was covered prior to a beneficiary becoming eligible for the Medicare Fee For Service (FFS) program. When a beneficiary receiving a DMEPOS item from another payer (including Medicare Advantage plans) becomes eligible for the Medicare FFS program, Medicare will pay for continued use of the DMEPOS item only if all Medicare coverage, coding and documentation requirements are met. Additional documentation to support that the item is reasonable and necessary, may be required upon request of the DME MAC.
For an item to be covered by Medicare, a detailed written order (DWO) must be received by the supplier before a claim is submitted. If the supplier bills for an item addressed in this policy without first receiving the completed DWO, the item will be denied as not reasonable and necessary.
A group 2 support surface is covered if the beneficiary meets at least one of the following three Criteria (1, 2 or 3):
The beneficiary has multiple stage II pressure ulcers located on the trunk or pelvis (described by the diagnosis codes listed in the table below) which have failed to improve over the past month, during which time the beneficiary has been on a comprehensive ulcer treatment program including each of the following:
Use of an appropriate group 1 support surface, and
Regular assessment by a nurse, physician, or other licensed healthcare practitioner, and
Appropriate turning and positioning, and
Appropriate wound care, and
Appropriate management of moisture/incontinence, and
Nutritional assessment and intervention consistent with the overall plan of care
The beneficiary has large or multiple stage III or IV pressure ulcer(s) on the trunk or pelvis (described by the diagnosis codes listed in the table below),
The beneficiary had a myocutaneous flap or skin graft for a pressure ulcer on the trunk or pelvis within the past 60 days (described by the diagnosis codes listed in the table below), and has been on a group 2 or 3 support surface immediately prior to discharge from a hospital or nursing facility within the past 30 days
If the beneficiary is on a group 2 surface, there should be a care plan established by the physician or home care nurse which includes the above elements. The support surface provided for the beneficiary should be one in which the beneficiary does not "bottom out" (see Appendices section).
When a group 2 surface is covered following a myocutaneous flap or skin graft, coverage generally is limited to 60 days from the date of surgery.
When the stated coverage criteria for a group 2 mattress or bed are not met, a claim will be denied as not reasonable and necessary.
A support surface which does not meet the characteristics specified in the Coding Guidelines section of the Pressure Reducing Support Surfaces – Group 2 Policy Article will be denied as not reasonable and necessary. (See Coding Guidelines and Documentation sections concerning billing of E1399.)
Continued use of a group 2 support surface is covered until the ulcer is healed, or if healing does not continue, there is documentation in the medical record to show that: (1) other aspects of the care plan are being modified to promote healing, or (2) the use of the group 2 support surface is reasonable and necessary for wound management.
Appropriate use of the KX modifier (see Documentation section) is the responsibility of the supplier. The supplier should maintain adequate communication on an ongoing basis with the clinician providing the wound care in order to accurately determine that use of the KX modifier still reflects the clinical conditions which meet the criteria for coverage of a group 2 support surface, and that adequate documentation exists in the medical record reflecting these conditions. Such documentation should not be submitted with a claim but should be available upon request.
HCPCS MODIFIERS:
EY – No physician or other licensed health care provider order for this item or service
GA – Waiver of liability statement issued, as required by payer policy, individual case
GZ – Item or service expected to be denied as not reasonable and necessary
KX - Requirements specified in the medical policy have been met
HCPCS CODES:
Group 1 Codes:
E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY)
E0277 POWERED PRESSURE-REDUCING AIR MATTRESS
E0371 NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH
E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS
E1399 DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS
Billing Guidelines with Modifiers - CPT A9270
C. Use of the GA, GY, and GZ Modifiers for Items and Supplies Billed to DMERCs.--The GY modifier must be used when suppliers want to indicate that the item or supply is statutorily noncovered (as defined in the PIM Chapter 1, §2.3.3.B) or is not a Medicare benefit (as defined in the PIM, Chapter 1, §2.3.3.A).
The GZ modifier must be used when suppliers want to indicate that they expect that Medicare will deny an item or supply as not reasonable and necessary and they have not had an Advance Beneficiary Notification (ABN) signed by the beneficiary.
The GA modifier must be used when suppliers want to indicate that they expect that Medicare will deny an item or supply as not reasonable and necessary and they do have on file an ABN signed by the beneficiary.
The GY and GZ modifiers should be used with the specific, appropriate HCPCS code when one is available. In cases where there is no specific procedure code to describe items or supplies, an NOC must be used with either the GY or GZ modifiers.
D. Use of the A9270.--Effective January 1, 2002, the A9270, Non-covered item or service, under no circumstances will be accepted for services or items billed to local carriers. However, in cases where there is no specific procedure code for an item or supply and no appropriate NOC code available, the A9270 must continue to be used by suppliers to bill DMERCS for statutorily non-covered items and items that do not meet the definition of a Medicare benefit.
E. Claims Processing Instructions.--At carrier and DMERC discretion, claims submitted using the GY modifier may be auto-denied. If the GZ and GA modifiers are submitted for the same item or service, treat the item or service as having an invalid modifier and therefore unprocessable.
ICD-10 Codes that Support Medical Necessity
ICD-10 CODE DESCRIPTION
L89.100 Pressure ulcer of unspecified part of back, unstageable
L89.102 Pressure ulcer of unspecified part of back, stage 2
L89.103 Pressure ulcer of unspecified part of back, stage 3
L89.104 Pressure ulcer of unspecified part of back, stage 4
L89.110 Pressure ulcer of right upper back, unstageable
L89.112 Pressure ulcer of right upper back, stage 2
L89.113 Pressure ulcer of right upper back, stage 3
L89.114 Pressure ulcer of right upper back, stage 4
L89.120 Pressure ulcer of left upper back, unstageable
L89.122 Pressure ulcer of left upper back, stage 2
L89.123 Pressure ulcer of left upper back, stage 3
L89.124 Pressure ulcer of left upper back, stage 4
L89.130 Pressure ulcer of right lower back, unstageable
L89.132 Pressure ulcer of right lower back, stage 2
L89.133 Pressure ulcer of right lower back, stage 3
L89.134 Pressure ulcer of right lower back, stage 4
L89.140 Pressure ulcer of left lower back, unstageable
L89.142 Pressure ulcer of left lower back, stage 2
L89.143 Pressure ulcer of left lower back, stage 3
L89.144 Pressure ulcer of left lower back, stage 4
L89.150 Pressure ulcer of sacral region, unstageable
L89.152 Pressure ulcer of sacral region, stage 2
L89.153 Pressure ulcer of sacral region, stage 3
L89.154 Pressure ulcer of sacral region, stage 4
L89.200 Pressure ulcer of unspecified hip, unstageable
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
L89.210 Pressure ulcer of right hip, unstageable
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
L89.220 Pressure ulcer of left hip, unstageable
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
L89.300 Pressure ulcer of unspecified buttock, unstageable
L89.302 Pressure ulcer of unspecified buttock, stage 2
L89.303 Pressure ulcer of unspecified buttock, stage 3
L89.304 Pressure ulcer of unspecified buttock, stage 4
L89.310 Pressure ulcer of right buttock, unstageable
L89.312 Pressure ulcer of right buttock, stage 2
L89.313 Pressure ulcer of right buttock, stage 3
L89.314 Pressure ulcer of right buttock, stage 4
L89.320 Pressure ulcer of left buttock, unstageable
L89.322 Pressure ulcer of left buttock, stage 2
L89.323 Pressure ulcer of left buttock, stage 3
L89.324 Pressure ulcer of left buttock, stage 4
L89.42 Pressure ulcer of contiguous site of back, buttock and hip, stage 2
L89.43 Pressure ulcer of contiguous site of back, buttock and hip, stage 3
L89.44 Pressure ulcer of contiguous site of back, buttock and hip, stage 4
L89.45 Pressure ulcer of contiguous site of back, buttock and hip, unstageable
N/A
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