L89.154 Pressure ulcer of sacral region, 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 sacral region, stage 4
• Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, sacral region

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)

Applies from L89.15 Pressure ulcer of sacral region

Applicable to

• Pressure ulcer of coccyx
• Pressure ulcer of tailbone

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)

• 707.03 Pressure ulcer, lower back (approximate)
• 707.24 Pressure ulcer, stage IV (approximate)

Code annotations containing back-references to L89.154

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

• L89.15 Pressure ulcer of sacral region
• L89.150 Pressure ulcer of sacral region, unstageable
• L89.151 Pressure ulcer of sacral region, stage 1
• 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 (this code)
• L89.156 Pressure-induced deep tissue damage of sacral region
• L89.159 Pressure ulcer of sacral region, unspecified stage
• L89.2 Pressure ulcer of hip
• L89.20 Pressure ulcer of unspecified hip
• L89.200 Pressure ulcer of unspecified hip, unstageable