2027 ICD-10-CM Diagnosis Code L89.154Pressure ulcer of sacral region, stage 4
ICD-10-CM Codes›L00–L99›L80-L99›L89
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 379
- Chronic Condition
L89.154 is a billable ICD-10-CM diagnosis code for pressure ulcer of sacral region, stage 4. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 573 through 575, 592 through 594. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 479 closely related codes. Coders also document this condition as pressure injury of back stage IV. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pressure ulcer of skin.
For Medicare Advantage risk adjustment, L89.154 maps to CMS-HCC Category 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) under the V28 model, adding a risk factor of about 1.965 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
L89.154 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Pressure injury of back stage IV
- Pressure injury of coccygeal region of back
- Pressure injury of coccygeal region of back stage IV
- Pressure injury of lower back stage IV
- Pressure injury of sacral region of back
- Pressure injury of sacral region of back stage IV
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to L89.154: its own notes plus those printed at L89 and Chapter 12. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- bed sore
- decubitus ulcer
- plaster ulcer
- pressure area
- pressure sore
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Healing pressure ulcer of sacral region, stage 4
- Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, sacral region
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- 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.-)
Code First
The underlying condition named in the note is sequenced before this code.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name L89.154, its category, or a range that includes it.
Excludes2 4
These codes carry an Excludes2 note naming L89.154: its condition is not part of those codes, and both may be reported when the patient has both.
- L97 Non-pressure chronic ulcer of lower limb, not elsewhere classifiedpressure ulcer (pressure area) (L89.-) names L89.-, which includes this code
- L98.4 Non-pressure chronic ulcer of skin, not elsewhere classifiedpressure ulcer (pressure area) (L89.-) names L89.-, which includes this code
- L98.A Non-pressure chronic ulcer of upper limb, not elsewhere classifiedpressure ulcer (pressure area) (L89.-) names L89.-, which includes this code
- M70 Soft tissue disorders related to use, overuse and pressurepressure ulcer (pressure area) (L89.-) names L89.-, which includes this code
Use Additional Code 1
These codes say to use an additional code from the note, and L89.154 is one of the codes named.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Pressure Ulcer
an ulceration caused by prolonged pressure on the skin and tissues when one stays in one position for a long period of time, such as lying in bed. the bony areas of the body are the most frequently affected sites which become ischemic (ischemia) under sustained and constant pressure.
Patient EducationClinical
Pressure Sores
Pressure sores are areas of damaged skin caused by staying in one position for too long. They commonly form where your bones are close to your skin, such as your ankles, back, elbows, heels and hips. You are at risk if you are bedridden, use a wheelchair, or are unable to change your position.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert L89.154 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About L89.154Overview
What is the ICD-10 code for pressure ulcer of sacral region, stage 4?
The ICD-10-CM code for pressure ulcer of sacral region, stage 4 is L89.154 (sometimes written as L89154). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is L89.154 (Pressure ulcer of sacral region) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pressure ulcer of sacral region, stage 4 on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does L89.154 group to?
When pressure ulcer of sacral region, stage 4 is the principal diagnosis on an inpatient stay, it groups to MS-DRG 592, 573, 574, 575, 593, 594, with relative weights from 0.7347 to 6.3547 depending on complications. Higher weights mean higher Medicare reimbursement.
Is L89.154 a CC or MCC?
CMS lists L89.154 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 479 closely related codes in its exclusion list.
What is coded first with L89.154?
The Code First note at L89, which applies to L89.154, reads: any associated gangrene (I96). When one of these applies, it is sequenced before L89.154.
What HCC is L89.154?
L89.154 (pressure ulcer of sacral region, stage 4) maps to CMS-HCC Category 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone), commonly written as HCC 379, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 157 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does L89.154 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, L89.154 adds a risk adjustment factor of about 1.965 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 1.420 to 2.580 depending on the payment segment). HCC 379 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 379 category page.
