Pressure Ulcers, Stage 2
The skin may not be broken at first, but if the pressure ulcer gets worse, it can form:
Grade 2. In Grade 2 pressure ulcers, some of the outer surface of the skin (the epidermis) or the deeper layer of skin (the dermis) is damaged, leading to skin loss [Figure 1b]. The ulcer looks like an open wound or a blister. The characteristics are:
What is a Stage 2 wound? In a Stage 2 wound the topmost layers of skin is severed (epidermis and dermis). There may be some drainage. Back to top What is a Stage 3 wound? Stage 3 wounds are deeper than stage 2 wounds. They typically go down to to the "fat" layer (subcutaneous), but do not extend any further. There may be dead tissue and drainage.
ICD-10 code L89. 152 for Pressure ulcer of sacral region, stage 2 is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue .
At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful. The sore expands into deeper layers of the skin. It can look like a scrape (abrasion), blister, or a shallow crater in the skin. Sometimes this stage looks like a blister filled with clear fluid.
Stage II pressure sores should be cleaned with a salt water (saline) rinse to remove loose, dead tissue. Or, your provider may recommend a specific cleanser. Do not use hydrogen peroxide or iodine cleansers. They can damage the skin.
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A grade 2 pressure ulcer is defined as partial-thickness skin loss involving the epidermis, dermis or both. The ulcer is superficial and presents clinically as an abrasion or blister (Figure 2).
Pressure Ulcer (Bedsore) StagesStage 1 ulcers have not yet broken through the skin.Stage 2 ulcers have a break in the top two layers of skin.Stage 3 ulcers affect the top two layers of skin, as well as fatty tissue.Stage 4 ulcers are deep wounds that may impact muscle, tendons, ligaments, and bone.
Currently, hydrocolloid dressings are widely used in individuals with Category/Stage II pressure ulcers.
Stage 2 injuries are a common result of an adverse microclimate (undesirable temperatures or skin surface moisture) and shear in the skin.
A Stage II pressure ulcer also may present as an intact or open/ruptured serum-filled blister. An easy way to remember this: Stage II ulcers are pink, partial, and may be painful. If any yellow tissue (slough) is noted in the wound bed, no matter how minute, the ulcer cannot be a Stage II.
“Two codes are needed to completely describe a pressure ulcer: A code from subcategory 707.0, Pressure ulcer, to identify the site of the pressure ulcer and a code from subcategory 707.2, Pressure ulcer stages.
A healed ulcer, on the other hand, does not need a code because it is an event that happened in the past, not a current event.
If a patient is admitted to an inpatient hospital with a pressure ulcer at one stage and it progresses to a higher stage, two separate codes should be assigned: one code for the site and stage of the ulcer on admission and a second code for the same ulcer site and the highest stage reported during the stay.
Ulcers are broadly classified based on the organ they are present. Each type of ulcer is further classified into acute or chronic.
F10 is the ICD-10 code for alcohol related disorders which is classified further into alcohol abuse (F10.1), alcohol dependence (F10.2), alcohol use, unspecified (F10.9). The F10 code can be further specified by the use additional codes. For example, blood alcohol level measurement is Y90.
Ulcer is one of the most frequently reported diagnosis codes in gastroenterology. However, with the advent of ICD-10, coding for the simple diagnosis has become complicated for even the most experienced doctors. To make your life a little easier, we compiled a list of accurate coding guidelines for ulcers that you could refer to for your next case.