Pressure-induced deep tissue damage of right heel

This code signifies a severe form of pressure injury affecting the right heel, characterized by persistent non-blanchable deep red, maroon, or purple discoloration, or a blood-filled blister. It indicates damage to the underlying soft tissue from pressure and/or shear, where the intact skin may or may not be present, but the extent of the injury is deeper than a Stage 2 pressure ulcer.

Apply this code when documentation explicitly states "deep tissue injury," "deep tissue damage," or "suspected deep tissue injury" of the right heel due to pressure. This diagnosis is typically made when the skin is intact but discolored, or a blood-filled blister is present, and the injury is known or suspected to extend into the subcutaneous tissue or deeper.

• Ensure the documentation clearly specifies "right heel" and "deep tissue damage" or "suspected deep tissue injury."
• Do not use this code for other stages of pressure ulcers; each stage has a distinct code.
• Sequence this code as a primary diagnosis if it is the reason for the encounter, or as a secondary diagnosis if it is a co-morbidity.