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HCC 382: Pressure Ulcer of Skin with Partial Thickness Skin Loss

HCC 382, Pressure Ulcer of Skin with Partial Thickness Skin Loss, is one of the 115 payment categories in the CMS-HCC V28 model. 25 ICD-10-CM codes map to it in the payment year 2027 mapping, and a documented diagnosis in the category adds a relative factor of 0.838 to the risk score of a community, non-dual, aged beneficiary (0.994 disabled, 0.343 institutional). It is overridden when a more severe category in its hierarchy is present (HCC 379, HCC 380, HCC 381) and it in turn overrides HCC 383.

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Data currency: ICD-10-CM to HCC mapping PY2027 initial (effective dates of service 2026, payment year 2027); CMS-HCC V28 model software V2826.115.T2 (effective payment year 2027). Next CMS release: PY2027 midyear final mapping (spring 2027) and PY2028 proposed model (February 2027).
Mapped ICD-10-CM codes
25
Factor, community non-dual aged
0.838
Factor, institutional
0.343
Hierarchy
Overridden by HCC 379, HCC 380, HCC 381
Disease group
Skin

Relative factors by segment

Each segment is a separate regression; the factor is added to the beneficiary's demographic factors and other categories, then normalized and reduced by the coding intensity adjustment before it meets the plan's base rate. A factor of 1.000 equals the expected cost of an average beneficiary.

CMS-HCC V28 relative factors for HCC 382 by model segment
SegmentModel codeRelative factor
Community, non-dual, agedCNA_HCC3820.838
Community, non-dual, disabledCND_HCC3820.994
Community, full-benefit dual, agedCFA_HCC3821.029
Community, full-benefit dual, disabledCFD_HCC3820.935
Community, partial-benefit dual, agedCPA_HCC3820.845
Community, partial-benefit dual, disabledCPD_HCC3820.937
Long-term institutionalINS_HCC3820.343

Hierarchy

Hierarchical condition categories pay only the most severe manifestation of a disease. When HCC 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) or HCC 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) or HCC 381 (Pressure Ulcer of Skin with Full Thickness Skin Loss) is also documented for the same beneficiary, HCC 382 is dropped from the score. When HCC 382 is present it drops HCC 383 (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle), so documenting the less severe condition alongside it adds nothing to payment but still matters for the clinical record.

HCC 379
Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone · 25 codes · factor 1.965
HCC 380
Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle · 152 codes · factor 1.078
HCC 381
Pressure Ulcer of Skin with Full Thickness Skin Loss · 50 codes · factor 1.075
HCC 383
Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle · 308 codes · factor 0.646

ICD-10-CM codes that map to HCC 382

25 codes map to this category in the PY2027 initial mapping. Descriptions are the CMS mapping descriptions for the FY2026 code set; a code that is deleted or split in the October code update stays valid for dates of service before the change.

ICD-10-CM codes mapped to HCC 382 in the CMS PY2027 initial mapping
ICD-10-CMDescription
L89002Pressure ulcer of unspecified elbow, stage 2
L89012Pressure ulcer of right elbow, stage 2
L89022Pressure ulcer of left elbow, stage 2
L89102Pressure ulcer of unspecified part of back, stage 2
L89112Pressure ulcer of right upper back, stage 2
L89122Pressure ulcer of left upper back, stage 2
L89132Pressure ulcer of right lower back, stage 2
L89142Pressure ulcer of left lower back, stage 2
L89152Pressure ulcer of sacral region, stage 2
L89202Pressure ulcer of unspecified hip, stage 2
L89212Pressure ulcer of right hip, stage 2
L89222Pressure ulcer of left hip, stage 2
L89302Pressure ulcer of unspecified buttock, stage 2
L89312Pressure ulcer of right buttock, stage 2
L89322Pressure ulcer of left buttock, stage 2
L8942Pressure ulcer of contiguous site of back, buttock and hip, stage 2
L89502Pressure ulcer of unspecified ankle, stage 2
L89512Pressure ulcer of right ankle, stage 2
L89522Pressure ulcer of left ankle, stage 2
L89602Pressure ulcer of unspecified heel, stage 2
L89612Pressure ulcer of right heel, stage 2
L89622Pressure ulcer of left heel, stage 2
L89812Pressure ulcer of head, stage 2
L89892Pressure ulcer of other site, stage 2
L8992Pressure ulcer of unspecified site, stage 2

Capturing and defending the category

A category counts for a payment year when a mapped diagnosis is documented at least once during the data collection year by an acceptable provider type at a face-to-face or audio-video encounter, and when the note shows the condition was monitored, evaluated, assessed or treated. Chronic conditions do not carry forward: a category that is not re-documented in the year drops out of the score, which is why annual wellness visits and problem-list reconciliation are where most recapture happens. Risk adjustment data validation audits sample enrollees and ask for the medical record behind each submitted category; an unsupported category is removed and, under the extrapolation rules, the error rate is applied across the contract. The QuickIntell risk adjustment product surfaces suspected and unsupported categories from the chart, and the HCC hub lists every V28 category with its factor and code count.

Frequently asked questions

Which ICD-10 codes map to HCC 382?

25 ICD-10-CM codes map to HCC 382 in the CMS PY2027 initial mapping, for example L89002 Pressure ulcer of unspecified elbow, stage 2; L89012 Pressure ulcer of right elbow, stage 2; L89022 Pressure ulcer of left elbow, stage 2; L89102 Pressure ulcer of unspecified part of back, stage 2. The full list is on this page; a code counts only when it is documented at a face-to-face or video encounter in the data collection year and supported by the record.

How much does HCC 382 add to a risk score?

The V28 relative factor for HCC 382 is 0.838 for a community, non-dual, aged beneficiary, 1.029 for full-benefit dual aged, 0.994 for non-dual disabled and 0.343 for long-term institutional members. A factor of 1.000 equals the expected annual cost of an average beneficiary, so the category's share of the payment follows the plan's base rate for that segment.

Does HCC 382 count together with related categories?

No. Within a hierarchy only the most severe category is paid. HCC 382 is dropped when HCC 379 (Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone) or HCC 380 (Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle) or HCC 381 (Pressure Ulcer of Skin with Full Thickness Skin Loss) is also present, and it drops HCC 383 when it is present.

What has to be documented for HCC 382 to be valid?

The diagnosis must be recorded by an acceptable provider type during a face-to-face or audio-video encounter in the service year, with the note showing that the condition was monitored, evaluated, assessed or treated. Risk adjustment data validation audits recover payment for categories the record does not support, so the code on the claim and the assessment in the note must match.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Relative factors and mappings are reproduced from the CMS risk adjustment model files as an operational reference. Payment depends on the plan's base rate, normalization, the coding intensity adjustment and the enrollee's segment. Not legal, clinical or billing advice.