Pressure Ulcer

“I am using for example a pressure ulcer right forefoot, 5th mpj area stage 1 as L89.811, but my biller is telling me it is an invalid code for pressure ulcer of MPJ stage 1. Any insight on how I should go forward since my understanding that a fourth character 6 is heel and 8 is other site of foot and 9 is unspecified site which is not recommended to use?”

“What code would you recommend for the excision of a pressure ulcer? Here is an excerpt from the operative report: “Attention was directed to the left plantar medical foot at the level of the arch where an approximately 3 cm round chronic ulceration with underlying bursa formation was noted. At this time, an elliptical incision was made in a 3:1 fashion running in line with the foot from toe to heel. This incision was deepened through subcutaneous tissues with care being taken to identify and retract all vital neurovascular structures. At this time, dissection scissors were utilized in order to remove the chronic ulceration with underlying bursa. The skin margins were then separated in order to free up and allow for skin closure.”