L89.004 Pressure ulcer of unspecified elbow, stage 4

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applicable to

• Healing pressure ulcer of unspecified elbow, stage 4
• Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, unspecified elbow

Applies from L89 Pressure ulcer

Includes

• bed sore
• decubitus ulcer
• plaster ulcer
• pressure area
• pressure sore

Excludes2 (not included here)

• decubitus (trophic) ulcer of cervix (uteri) (N86)
• diabetic ulcers (E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621, E13.622)
• non-pressure chronic ulcer of skin (L97.-)
• skin infections (L00-L08)
• varicose ulcer (I83.0, I83.2)

Code first

• any associated gangrene (I96)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 379 — Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
• CMS-HCC V22: HCC 157 — Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone
• ESRD V24: HCC 157

MS-DRG index

Defines the logic of DRG(s) 573-575 in MDC 09.

Approximate ICD-9-CM (GEMs)

• 707.01 Pressure ulcer, elbow (approximate)
• 707.24 Pressure ulcer, stage IV (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Code annotations containing back-references to L89.004

Back-references to L89

• Use Additional: G90.4 Autonomic dysreflexia ("pressure ulcer (pressure area) (L89.-)")
• Type 2 Excludes: L97 Non-pressure chronic ulcer of lower limb, not elsewhere classified ("pressure ulcer (pressure area) (L89.-)")
• Type 2 Excludes: L98.4 Non-pressure chronic ulcer of skin, not elsewhere classified ("pressure ulcer (pressure area) (L89.-)")
• Type 2 Excludes: L98.A Non-pressure chronic ulcer of upper limb, not elsewhere classified ("pressure ulcer (pressure area) (L89.-)")
• Type 2 Excludes: M70 Soft tissue disorders related to use, overuse and pressure ("pressure ulcer (pressure area) (L89.-)")

Nearby codes

• L89.00 Pressure ulcer of unspecified elbow
• L89.000 Pressure ulcer of unspecified elbow, unstageable
• L89.001 Pressure ulcer of unspecified elbow, stage 1
• L89.002 Pressure ulcer of unspecified elbow, stage 2
• L89.003 Pressure ulcer of unspecified elbow, stage 3
• L89.004 Pressure ulcer of unspecified elbow, stage 4 (this code)
• L89.006 Pressure-induced deep tissue damage of unspecified elbow
• L89.009 Pressure ulcer of unspecified elbow, unspecified stage
• L89.01 Pressure ulcer of right elbow
• L89.010 Pressure ulcer of right elbow, unstageable
• L89.011 Pressure ulcer of right elbow, stage 1