The direction in the new guideline means that it is inappropriate to assign codes that report unstageable pressure ulcers, or pressure ulcers classified as stage 1-4, for a diagnosis of pressure-induced deep-tissue damage or deep-tissue pressure injury. “For pressure-induced deep-tissue damage or deep-tissue pressure injury, assign only the appropriate code for pressure-induced deep-tissue damage (L89.-6).”
I.C.12.a.7 Pressure-Induced Deep-Tissue Damage ICD-10-CM 2020 contains a new guideline directing how codes for deep-tissue pressure injury are to be assigned, as outlined below: The updates introduce a new fifth or sixth character of “6” to specifically classify instances of pressure-induced deep-tissue injury.Įxample: L89.01 6 Deep tissue pressure injury of right elbow
Previously, coding guideline I.C.12.a.2 directed that these injuries also be reported with a fifth or sixth character representing an unstageable pressure ulcer. Codes in this category have a fifth or sixth character that identifies the pressure ulcer’s stage. The codes for pressure-induced deep-tissue injury are found in the L89, Pressure Ulcer code category. Associated symptoms include pain at the site of compromised tissue, and differences in tissue consistency or temperature when compared to adjacent tissue. Because they form in deep tissue, these ulcers may not be visible until they are far advanced, and they may be harder to recognize in patients with darker skin tone. These injuries can also present as blood blisters. The injury is characterized by purple or maroon areas of intact skin. Pressure-induced deep-tissue damage is a serious form of pressure ulcer caused by direct pressure to the skin and soft tissue that causes ischemia. What is Pressure-Induced Deep-Tissue Damage? These changes include the addition of new codes for the reporting of pressure-induced deep-tissue damage, also known as deep-tissue pressure injury (DTPI), and a new chapter-specific guideline that provides direction on how these codes are assigned. The 2020 updates to ICD-10-CM contain some significant changes to Chapter 12, Diseases of the Skin and Subcutaneous Tissue. Providers should review their protocols to prepare for the changes.
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