153 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 1 Depending upon the skin areas exposed to urine or stool and/or the use of containment devices, IAD can also extend to the. an ulcer. Differential diagnosis includes stage 2 pressure ulcers, incontinence-associated dermatitis, skin tears, bruising, haematoma, venous engorgement, arterial insufficiency, necrotising fasciitis and terminal skin ulcers. L89313 Pressure ulcer of right buttock, stage 3 L89010 Pressure ulcer of right elbow, unstageable L89314 Pressure ulcer of right buttock, stage 4 L89013 Pressure ulcer of right elbow, stage 3 L89320 Pressure ulcer of left buttock, unstageable L89014 Pressure ulcer of right elbow, stage 4 L89323 Pressure ulcer of left buttock, stage 3 L89020. It is the most common site of intra. Muscle. Surgical debridement and antiseptic dressings were done for ulcer management. )ICD-10-CM Diagnosis Codes. The purpose of this compendium is to describe and illustrate conditions that may mimic pressure ulcers/injuries. viral warts ( B07. Moderate Erythema. Chapter 12 - Diseases of the skin and subcutaneous tissue (L00-L99) » Other disorders of the skin and subcutaneous tissue (L80-L99) » Pressure ulcer of right buttock, stage 4 (L89. 301 became effective on October 1, 2023. A stage 2 pressure ulcer may appear as a shallow, crater-like wound or a blister containing a clear or yellow fluid. This is the American ICD-10-CM version of L98. Pus or blood leaking from an opening in the skin. 4 may differ. you could use foam, or hydrocolloid if that is what you use. 7%. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code L97. For example, “The wound is located in the mid-line at the level of the iliac crests; therefore, it is determined to be a sacral prominence pressure ulcer”. 222 for Pressure ulcer of left hip, stage 2 is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue . Subscribe to Codify by AAPC and get the code details in a flash. 92 may differ. INTRODUCTION. 54L89. 3 is a non-billable code. 1 The latter name, although. These lesions mostly occur in. Posterior view and B. Run. 19 . •Surgical debridement of a pressure ulcer does not create a surgical wound. 3 - other international versions of ICD-10 L89. 3 became effective on October 1, 2023. Results of the 2008-2009 International Pressure Ulcer Prevalence™ Survey and a 3-year, acute care, unit-specific analysis. ICD Code L89. The severity of the sacral PU was considered as a secondary outcome. 0): 573 Skin graft for skin ulcer or cellulitis with mcc; 574 Skin graft for skin ulcer or cellulitis with ccA decubitus ulcer, also known as a pressure ulcer, pressure sore, or bed sore, is an open wound on the skin [1-5]. The 2024 edition of ICD-10-CM L89. 90 became effective on October 1, 2023. et al (2008) Pressure ulcers: e-learning to improve classification by nurses and nursing students. ICD-10-CM Codes. 313 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Multivariate logistic regression analysis was conducted on the end point of facility-acquired sacral/buttock pressure injury and the risk factors of immobility and type of incontinence. Healing pressure ulcer of unspecified buttock, stage 2. ICD-10-CM Code for Pressure ulcer of unspecified buttock, stage 2 L89. This is the American ICD-10-CM version of L89. In the pressure ulcer, the most important etiologic factor. They should receive prompt treatment; otherwise, complications associated with. Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combination with shear or friction. g. Pressure ulcers often occur on bony areas, such as the heels and elbows. For example, the pannus or abdominal skin folds, inner gluteal cleft, and axillae are some common anatomical locations of ITD. 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. 32 contain annotation back-references that may be applicable to L89. It should be included in the reconstructive algorithm for the management of sacral pressure ulcers. 42 may differ. 22 became effective on October 1, 2023. ill and in bed or sitting in a chair or wheelchair without the pressure being relieved. 419 may differ. The gluteal fold is formed by the fibrous attachment of the gluteal skin to the deep fascia, while the lower. One of the most effective ways of preventing pressure ulcers on the buttocks and the rest of the body is making regular, frequent changes to your position. Cause - Pressure ulcer occurs due to the prolonged pressure or shear to the particular part of the body while in moisture lesions, there may be desiccation and loose skin. 0):. Chemical burns due to disinfectants are primary irritant dermatitis caused by. 30 Pressure ulcer of unspecified buttock. An odor from draining pus. 31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. But in SGD, ulcers are developed in lower position of gluteal cleft than pressure sore which happen due to force abrasively folded inward in both buttocks (Fig. 322 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. It is also known by other more complicated names, such as gluteal senile dermatosis or hyperkeratotic lichenified skin lesion of the gluteal region. Keywords: gluteal flap, fasciocutaneous flap, myocutaneous. 21 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. The bruise becomes an open sore that looks like an abrasion or blister. . Abstract Fletcher, J. Medical Care. 0b013e31828f1a2e The damaging effects of moisture, pressure, friction, and shear on human tissue are well-known among wound care. But in SGD, ulcers are developed in lower position of gluteal cleft than pressure sore which happen due to force abrasively folded inward in both buttocks (Fig. ICD-10-CM Codes. The damaging effects of moisture, pressure, friction, and shear on human tissue are well-known among wound care experts. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2024 ICD-10-CM Range L00-L99. 323 is a billable ICD code used to specify a diagnosis of pressure ulcer of left buttock, stage 3. The 2024 edition of ICD-10-CM L89. 09 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 707. or. After skin is prepared, remove the centre release film by gentlyApproximate Synonyms. It’s usually asymptomatic unless a cyst or an abscess forms over the sinuses in your butt crack. Q82. FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. A sacral decubitus ulcer is the medical term for pressure ulcers that appear on the skin over a boney region of the spine called the sacrum. 31 may differ. Symptoms of intertrigo include a red or reddish-brown rash that can appear anywhere skin rubs together or traps wetness. FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This disease causes a lot of physical and mental damage to the patient. “Pressure ulcer”: External force applied to the body reduces or blocks the blood flow of the soft tissue between bone and the superficial layer of the skin. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. ICD-9-CM 707. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). IAD and ITD are superficial lesions that. 323 - other international versions of ICD-10 L89. 419 became effective on October 1, 2023. This is the American ICD-10-CM version of L98. Triad is a sterile coating that can be applied directly onto the wound or peri-wound skin. L89. center release film and apply dressing into the gluteal cleft and then the sacral area. ICD-10 code L89. Continue to release dressing from skin using handling tabs . pressure ulcer, the most important etiologic factor is . 411 Non-pressure chronic ulcer of buttock limited to breakdown of skin Billable; L98. 0):. 524 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. L89. 312 may differ. 90 - other international versions of ICD-10 L89. This is a sign that a pressure ulcer may be forming. This is the American ICD-10-CM version of L89. Request a. 159 - other international versions of ICD-10 L89. 312 became effective on October 1, 2023. Recent consensus work has identiied gaps in our current understanding and practice . The superior cluneal nerve can be included in the design. The pressure ulcers on the buttocks are documented as full thickness skin loss with necrosis into the subcutaneous tissue. -) non-pressure chronic ulcer of skin ( L97. 321Pressure ulcer of left buttock, stage 1. This is the American ICD-10-CM version of L89. 3 - Cutaneous abscess, furuncle and carbuncle of buttock. It can be applied anywhere on the body and adheres to wet skin, while keeping the wound covered to facilitate healing and debridement. The pressure ulcers on the buttocks are documented as full thickness skin loss with necrosis into the subcutaneous tissue. Moisture lesions often have diffuse or irregular edges. L89. L02. ⑩ [Billable] There's more to see -- the rest of this topic is available only to subscribers. 1 The classic findings, found in 50% of cases, include perianal and peristomal skin tags, fistulae, perineal ulcers, linear ulcers (resembling knife cuts), abscesses, and fissures. There are a group of patients who develop DTIs as very linear wounds with a mirror image distribution, along the edge of the medial buttocks, right along the gluteal cleft. Short description: Non-pressure chronic ulcer of buttock with unsp severity The 2024 edition of ICD-10-CM L98. But in SGD, ulcers are developed in lower position of gluteal cleft than pressure sore which happen due to force abrasively folded inward in both buttocks . 324Pressure ulcer of left buttock, stage 4. Let me give you an easy run down of how to stage pressure ulcers. org In buttock area, pressure ulcers are prone to occur in skin area on the sacrum, ischial tuberosity, and femoral trochanter 5. To Remove Gently lift the border and use one hand to stabilize the. 0):. 32 became effective on October 1, 2023. The 2024 edition of ICD-10-CM L89. Pressure Ulcer / therapy*. L89. Synonyms: pressure injury of buttock stage ii. You must seek immediate medical treatment if you have a stage 3 pressure ulcer. This is the American ICD-10-CM version of L89. Pressure ulcer has tendency to happen the skin area of bony prominence, es-ICD-10 code L89. 311 became effective on October 1, 2023. Pressure Ulcers (Pressure Injuries) Pressure ulcers occur when pressure causes damage to the skin. L89. 302 - Pressure ulcer of unspecified buttock, stage 2. 322 - other international versions of ICD-10 L89. Codes marked as Billable can be used in all HIPAA-covered transactions. 28 yr female presenting with non healing ulcer in intra gluteal cleft of for 3 months. The sacral region includes the tailbone and the coccyx. 151 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Prevention is of the utmost importance. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . L02 - Cutaneous abscess, furuncle and carbuncle. MASD is inflammation and erosion of the skin caused by prolonged exposure to various sources of moisture, including urine/stool, perspiration, exudate, ostomy effluent, mucus, and saliva. 301 may differ. 4 - other international versions of ICD-10 L98. 7. Prep solution usually pools along the side of the patient, not in the gluteal cleft. An anatomic variant of psoriasis, “inverse psoriasis” is characterized by the involvement of skin-fold areas such as the inguinal folds, axillary folds, inframammary folds, retroauricular area, and gluteal cleft rather than the more common psoriatic involvement of the trunk, extensor surfaces of the extremities, and scalp. 303 became effective on October 1, 2023. A step-by-step drawing of the surgical process. ↓ See below for any exclusions, inclusions or special notations. L02. Pressure ulcer (L89) Pressure ulcer of left buttock, unstageable (L89. Differential diagnosis includes stage 2 pressure ulcers, incontinence-associated dermatitis, skin tears, bruising, haematoma, venous engorgement, arterial insufficiency, necrotising fasciitis and terminal skin ulcers. Pressure ulcer has tendency to happen the skin area of bony prominence, es-the gluteal cleft. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or. Remove the tibia and fibula. L89. 5. Wound Healing*. Your doctor may prescribe antibiotic therapy and remove any dead. L89. Use. Prompt and accurate diagnosis is important to determine the best plan of treatment. 892 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Unstageable pressure injuries are widely understood to be full-thickness pressure injuries in which the base is obscured by slough and/or eschar. A pilonidal cyst can be extremely painful especially when sitting. Ulcers in SGD on the cleft of the buttock should be differ-. L89. AHRQ QI™ ICD-9-CM and ICD-10-CM/PCS Specification Enhanced Version 5. Healing pressure ulcer of left buttock, stage 4; Pressure ulcer with necrosis of soft tissues through to underlying muscle, tendon, or bone, left buttock; Includes Excludes I Excludes II Notes From Chapter 12: certain conditions originating in the perinatal period (P04-P96) certain infectious and parasitic diseases (A00-B99). 893 became effective on October 1, 2023. Incontinence associated dermatitis: Skin damage is focused around perianal and perineal areas, as well as often inner thighs, buttocks and groin. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . Making the correct differential diagnosis is important to develop and. Diseases of the skin and subcutaneous tissue. Stage I: A reddened, painful area on the skin that does not turn white (blanch) when pressed. The 2024 edition of ICD-10-CM L89. Pressure ulcer has tendency to happen the skin area of bony prominence, es- Intertriginous skin, also known as skin folds, are sites in which opposing skin surfaces come into contact while at rest, resulting in chronic skin occlusion. Pressure ulcer of right buttock, stage 3. 8; 95% CI 1. L89. 893 - other international versions of ICD-10 L89. The 2024 edition of ICD-10-CM L89. • The earlier pressure ulcers are found, the more easily they can be treated. 524 - other international versions of ICD-10 L89. Differential assessment of trunk wounds:. 223 became effective on October 1, 2023. 22 may differ. Inflamed, swollen skin. This is the American ICD-10-CM version of L89. 304 for Pressure ulcer of unspecified buttock, stage 4 is a medical classification as listed by WHO under the range - Diseases. 14 states that the stage of the pressure ulcer may be documented by another healthcare clinician and coded as long as the pressure ulcergluteal cleft5 Sacral pressure ulcer prevention considerations: • Assess patient for pressure ulcer risk. A pressure ulcer that has been surgically debrided should continue to be coded as a pressure ulcer. BILLABLE | ICD-10 from 2011 - 2016. Author Jacqui Fletcher, MSc, BSc, PG Cert ILT, RGN, is principal lecturer, tissue viability, University of Hertfordshire. 1. L89. 819A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. Surgical debridement and antiseptic dressings were done for ulcer management. . (Avoid hydrogen peroxide or iodine cleaners, which can damage your skin. Pressure ulcers are full-thickness lesions located over bony prominences or under medical devices. 32 - Pressure ulcer of left buttock; L89. stage 3 of the right hip. 8 may differ. L89. Terms like “buttock” are imprecise and could represent any area from the sacrum to the ischial spines. If you've. Standard wound care was provided that included debridement, topical. Non-pressure chronic ulcer of buttock with necrosis of bone. The 2024 edition of ICD-10-CM L89. 31) L02. 5%; persons with skin injury were more likely to have fecal incontinence than urinary incontinence (45. L89. L98. 2 Definition of Pressure Ulcers A pressure ulcer is defined as ‘an area of localised damage to the skin, muscle and/or underlying tissue, caused by shear, friction or unrelieved pressure, usually over bony. 322 may differ. Read about recovery time, diagnostic tests, and prevention. 150. Short description: Non-pressure chronic ulcer of buttock limited to brkdwn skin The 2024 edition of ICD-10-CM L98. The diffuse surrounding enhancement (arrowhead) indicates superimposed infection. This is the American ICD-10-CM version of L89. 523 for Pressure ulcer of left ankle, stage 3 is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue . This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information. 312 is a billable diagnosis code used to specify pressure ulcer of right buttock, stage 2. This is the American ICD-10-CM version of L89. 707. The 2024 edition of ICD-10-CM L89. Stage I is the mildest stage. 31 - other international versions of ICD-10 L02. The superior tip of the intergluteal cleft. 411 - Non-pressure chronic ulcer of buttock limited to breakdown of skin. 2. This outer layer can be damaged in many ways and a common cause of damage is through moisture. Billable Thru Sept 30/2015. Keep the wound clean with mild soap and water or a saline rinse as directed. This is the American ICD-10-CM version of S31. 418 ICD-10 code L98. In buttock area, pressure ulcers are prone to occur in skin area on the sacrum, ischial tuberosity, and femoral trochanter 5. moisture lesions and pressure ulcers beeckman, D. 90 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. ICD-10-CM Code for Pressure ulcer of left buttock L89. 5. The wound was initially covered with a foam dressing. of gluteal cleft, with dressing ‘base’ positioned to cover coccyx area. 411 - other international versions of ICD-10 L98. Unspecified open wound of right buttock, initial encounter. 93: Avg LOS at DRG: 22. The 2024 edition of ICD-10-CM L89. 223 - other international versions of ICD-10 L89. 322 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Consultations for his ulcer were undertaken on day 24, at which time he was noted to have a large black eschar on his left gluteal region (Figure (Figure2B). 3 that describes the diagnosis 'pressure ulcer of buttock' in more detail. The 2024 edition of ICD-10-CM L03. Pressure ulcers usually form on bony parts of the body, such as the heels, elbows, hips and tailbone. 303 may differ. brownish plaques on the gluteal cleft and each side of the buttocks. 221 is a valid billable ICD-10 diagnosis code for Pressure ulcer of left hip, stage 1 . Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. L89. R22. Remove the tibia and fibula. prevalence of these ulcers is unknown due to the mixture of reporting styles. Grade 1 pressure ulcers do not turn white when pressure is placed on them. Pressure ulcers are a common occurrence in debilitated patients. categorized as a pressure injury. Access to this feature is available in the following products: Find-A-Code Essentials. L89. a linear wound in the natal cleft between the buttocks or on the cheeks of the buttocks, with a wound often being present on both. Short description: Pressure ulcer, site NEC. 75-year-old man with a pressure ulcer clinically. After skin is prepared, remove the centre release film by gentlyCode History. 153 for Pressure ulcer of sacral region, stage 3 is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue . They happen when you lie or sit in one position too long and the weight of your. 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma with. 2014. 9] Findings: The skin looks macerated directly in the midline, this is the upper sacrum and the lowermost extent is about 3 fingerbreadths from. L89. not visible . The 2024 edition of ICD-10-CM L89. 32 may differ. ICD-10-CM Code for Pressure ulcer of contiguous site of back, buttock and hip L89. Lawsuits have been lost when a severe pressure ulcer on the sacrum was linked to incontinence-associated dermatitis that occurred months before in the gluteal cleft, because both locations were simply described as the “buttocks. 309 became effective on. Stage II: The skin blisters or forms an open. Applicable To. This is the American ICD-10-CM version of L89. A Practical Approach to the. L98. In response to an initiative spearheaded by the Wound, Ostomy and Continence Nurses Society (WOCN), new diagnosis codes for moisture-associated skin damage (MASD) were added to the current version of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). 321. 801A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. The superficial skin is less susceptible to pressure-induced damage than deeper tissues. of a stage III pressure ulcer . People confined to bed will need to change their position at least once every two hours. Pressure ulcer of other site, stage 2. L89. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information. These also recreate a vertical gluteal cleft. 320 - other international versions of ICD-10 L89. Pressure ulcer, buttock. 153 became effective on October 1, 2023. BILLABLE | ICD-10 from 2011 - 2016. L89. stages. 2024 ICD-10-CM Range L00-L99. Subscribe to Codify by AAPC and get the code details in a flash. Nevertheless, accurate classification of these lesions is frequently challenging, even for experienced wound clinicians. Lawsuits have been lost when a severe pressure ulcer on the sacrum was linked to incontinence-associated dermatitis that occurred months before in the gluteal cleft, because both locations were simply described as the “buttocks. prominence, such as the buttock (sacrum/ischium), heels, hips (trochanter), elbows, ankles. Seven Cases of Senile Gluteal Dermatoses Developed with Ulcer Min-Jae Gwak, Mu-Hyoung Lee, Min Kyung Shin Department of Dermatology, College of Medicine, Kyung. Ostomy Wound Management, 2009;55(11):39-45. 890 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for. gallstones, kidney stones, liver disease, diseases of the female reproductive, and. [4] However, its rapid deterioration to a full-thickness injury is unlike a true. The 2024 edition of ICD-10-CM L89. 899 became effective on October 1, 2023. Damage control: Differentiating incontinence-associated dermatitis from pressure injury Nursing. Intergluteal cleft rashes, also known as intertrigo, are a common inflammatory skin condition caused by skin-to-skin friction and intensified by heat and moisture. 012 Pressure ulcer of right elbow, stage 2 L89. Ostomy Wound Management, 2009;55(11):39-45. Remove the right-side release film and gently smooth this side of the dressing into place. These lesions are also often mistakenly labeled stage 1 or stage 2 pressure ulcers/injuries. Initial management included needle-guided. Pressure ulcers, also called decubitus ulcers, bedsores, or pressure sores, range in severity from reddening of the skin to severe, deep craters with exposed muscle. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. 1. The correct codes and sequence are: L89. This is the American ICD-10-CM version of L89. It is found in the 2023 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2022 - Sep 30, 2023 . This is one reason why knowing what to expect after a craniotomy is important. What is gluteal ulcer? In buttock area, pressure ulcers are prone to occur in skin area on the sacrum, ischial tuberosity, and femoral trochanter5. L98. Pain. 321 - Pressure ulcer of left buttock, stage 1. Terms like “buttock” are imprecise and could represent any area from the sacrum to the ischial spines. 2024 ICD-10-CM Range L00-L99. Applicable To. The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, [1] so named because it forms the visible border between the external rounded protrusions of the gluteus maximus muscles. 300 became effective on October 1, 2023. Code History. L89. The 2024 edition of ICD-10-CM L98. Pressure ulcer of unspecified buttock, unstageable. 309 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. L89. Located in peri-anal, gluteal, cleft, groin or buttock area. 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma with mcc; 964 Other. L89. L89. 322 became effective on October 1, 2023. Identify how management of moisture lesions may differ from that of pressure ulcers. This search was based on the key terms "surface anatomy," "skin," "buttocks," and "gluteal area. 32 ICD-10 code L89. L89. The 2024 edition of ICD-10-CM L89. DX? If this is your first visit, be sure to check out the FAQ & read the forum rules. -) 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM) damage, pressure ulcers Background In 2010, WOCN members were asked to respond to a. After evaluating a zinc oxide-based hydrophilic paste on intergluteal cleft lesions the institiution's value analysis team added the hydrophilic paste to the wound care formulary. Thepatients withgiantcelltumor, rhabdomyosarcoma, andmetastatic thyroid carcinoma had associated bonedestruction. Predisposing factors are classified as intrinsic (e. Combination Lesions: These are lesions where a combination of pressure and moisture contribute to the tissue breakdown. 3.