Pressure ulcer of left heel, stage 1

This code signifies the earliest stage of a pressure-related skin injury located on the left heel. It involves non-blanchable erythema of intact skin, indicating a localized area of persistent redness that does not turn white when pressed. This stage reflects superficial damage to the skin, but it is a critical indicator of potential deeper tissue injury if not addressed.

Apply this code when documentation explicitly states a pressure ulcer on the left heel is at Stage 1. This typically involves a physical assessment noting intact skin with non-blanchable redness. Ensure the medical record clearly identifies the anatomical site (left heel) and the specific stage (Stage 1).

• Always confirm the specific anatomical location and the documented stage of the pressure ulcer.
• Differentiate from other skin conditions like dermatitis or cellulitis, which may present with redness but are not pressure-related.
• Do not use this code if there is any break in the skin, such as an abrasion, blister, or open wound, as that would indicate a higher stage.