Pressure ulcer with abrasion, blister, partial thickness skin loss involving epidermis. 320 - other international versions of ICD-10 L89. 892 - other international versions of ICD-10 L89. Stage I is the mildest stage. 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. Request a Demo 14 Day Free Trial Buy Now. 3 may differ. 322 - other international versions of ICD-10 L89. Not usually over a bony prominence Depth Superficial partial thickness skin loss Can enlarge or deepen if infection presentPressure ulcers do cause discomfort or pain owing to ischemia and tissue damage [3], and physical problems that cause complications, lead to poor clinical outcomes, psychological, and social. with pressure ulcer is most important. . 311 became effective on October 1, 2023. 21 - other international versions of ICD-10 L89. Subscribe to Codify by AAPC and get the code details in a flash. Applicable To. L89. g. Ostomy Wound Management, 2009;55(11):39-45. Background: Sacral and gluteal pressure wounds are a common problem in elderly and critically ill patients. A 'billable code' is detailed enough to be used to specify a medical diagnosis. The most widely accepted theory for pilonidal sinus disease development begins with a hair follicle in the intergluteal cleft becoming infected. 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. 3 a. L98. HCC Plus. The 2024 edition of ICD-10-CM L89. 321Pressure ulcer of left buttock, stage 1. This is the American ICD-10-CM version of L89. This is the American ICD-10-CM version of Q82. 0):. g. Terms like “buttock” are imprecise and could represent any area from the sacrum to the ischial spines. -) non-pressure chronic ulcer of skin ( L97. Continue Reading. Pressure ulcers are a common occurrence in debilitated patients. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code L97. 2018 Jun;48(6):18-25. 300 became effective on October 1, 2023. Pressure-induced skin and soft tissue injuries are localized areas of damage to the skin and/or underlying tissue usually over a bony. 412 - Non-pressure chronic ulcer of buttock with fat layer exposed. ICD-10-CM Code L89. Ostomy Wound Management, 2009;55(11):39-45. (2008)Symptoms. Medical Care. 5 million patients in US. It can be applied anywhere on the body and adheres to wet skin, while keeping the wound covered to facilitate healing and debridement. 142 for Pressure ulcer of left lower back, stage 2 is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue . 42 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. beeckman, D. This chapter reviews the operative technique for using different types of gluteal flaps as coverage for sacral pressure sores. L02. The damaging effects of moisture, pressure, friction, and shear on human tissue are well-known among wound care experts. AFT feature is designed to provide pressure distribution via a fluid-like medium that forces air though millions of tiny silicone beads that float the patient's body to achieve maximum immersion and envelopment. What is the diagnosis code for a stage 3 gluteal cleft pressure ulcer? Are two codes required in order to capture the correct location since the gluteal cleft appears to be between both sides of the buttocks?. Remove the tibia and fibula. Code History. From urine or faeces – rather than pressure) Pressure ulcer of unspecified buttock, unspecified stage. 21 is an approximate match for comparison and. L89. Is Z98 890 a billable code? Z98. 4 became effective on October 1, 2023. The most common sites are the skin. Pressure sores on the buttocks are due to long periods of uninterrupted pressure on the skin, soft tissue, muscle and bone. 411 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Applicable To. 54L89. MASD is distinct from damage due to pressure, vascular insufficiency, neuropathy, or other factors, but the development of a wound may be associated with several risk factors. The 2024 edition of ICD-10-CM L89. BILLABLE | ICD-10 from 2011 - 2016. Subscribe to Codify by AAPC and get the code details in a flash. 4 may differ. ↓ See below for any exclusions, inclusions or special notations. Healing pressure ulcer of other site, stage 3. Pressure ulcer with abrasion, blister, partial thickness skin loss involving epidermis and. Shape - Pressure ulcers are circular wounds with a regular shape limited to a single spot while moisture lesions can be different superficial spots. ICD-10-CM Codes. There are three primary risk factors to developing a pressure ulcer: immobility, increased pressure on a section of skin, and an interruption of the blood flow. This is the American ICD-10-CM version of L89. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. Synonyms: pressure injury of buttock stage ii. Combination Lesions: These are lesions where a combination of pressure and moisture contribute to the tissue breakdown. Thepatients withgiantcelltumor, rhabdomyosarcoma, andmetastatic thyroid carcinoma had associated bonedestruction. L89. 4 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. Applicable To. 411 is a billable ICD code used to specify a diagnosis of non-pressure chronic ulcer of buttock limited to breakdown of skin. 3 - Cutaneous abscess, furuncle and carbuncle of buttock. 418 for Non-pressure chronic ulcer of buttock with other specified severity is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue . After skin is prepared, remove the centre release film by gentlyCode History. ICD-10 code L89. of a stage III pressure ulcer . Unstageable pressure injuries are widely understood to be full-thickness pressure injuries in which the base is obscured by slough and/or eschar. 151. L98. 153 became effective on October 1, 2023. Most anesthesiologists choose to use general endotracheal anesthesia, particularly if the patient is prone, but ulcer closure may be performed under regional or local anesthesia if necessary. The CLP feature of the bed provides pressure distribution for the upper body. Healing pressure ulcer of unspecified buttock, stage 2. It’s important not to mistake the transverse gluteal fold for the lower border of the gluteus maximus muscle. 313 - other international versions of ICD-10 L89. An evidence‐based overview of dressings for pressure ulcers is needed to enable informed decision‐making on dressing use. Causes. The 2024 edition of ICD-10-CM L89. The skin's most outer layer called the stratum corneum provides a protective barrier. Pressure pre-ulcer skin changes limited to persistent focal edema. Diet. 324 became effective on October 1, 2023. The superficial skin is less susceptible to pressure-induced damage than deeper tissues. 31 - other international versions of ICD-10 L89. Pressure ulcer of right buttock, stage 1. A non-healing wound, such as an ulcer, is not coded with an injury code beginning with the letter S. Male/female ratio was 130/7. The 2024 edition of ICD-10-CM L89. Signs and symptoms of gluteal injuries include swelling, bleeding, and inflammation. Prevention is of the utmost importance. ICD-10 code L89. 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 . 819A became effective on October 1, 2023. and Etiology of Buttock Ulcers Example of wording for Early IAD: “After assisted to a semi-prone position for exam, dry, intact erythematous skin is observed surrounding the anus and along both sides of the gluteal cleft from bilateral gluteal creases to the top of the gluteal cleft. 317 may differ. Decubitus means pressure, while the term ulcer. This Guide is intended to help you and those who assist with your care learn how to prevent pressure ulcers. Pressure ulcer has tendency to happen the skin area of bony prominence, es-the gluteal cleft. Unspecified open wound of right buttock, initial encounter. 2024 ICD-10-CM Range L00-L99. 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. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. 32 became effective on October 1, 2023. Deep tissue injury (DTI) pressure ulcers are defined as ‘purple or maroon localized area of discolored intact skin or blood‐filled blister due to damage of underlying. In contrast, pressure ulcers on the ischium develop when the patient is seated upright. They occur from immediately after surgery in areas such as lateral to, or above, the gluteal cleft. 222 Pressure ulcer of left hip, stage 2. of gluteal cleft, with dressing ‘base’ positioned to cover coccyx area. Request a. The 2024 edition of ICD-10-CM L98. Subscribe to Codify by AAPC and get the code details in a flash. Pressure ulcer of left buttock, stage 2. Pressure ulcer with abrasion, blister, partial thickness skin loss involving. 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 . In this study, suture anchors were used in sacral pressure ulcer reconstruction, aiming at secure midline attachment of gluteal fasciocutaneous flaps, obliteration of any dead space, and recreation of the natal cleft. 223 - other international versions of ICD-10 L89. 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. 323 Pressure ulcer of left buttock, stage 3 L89. Gently pull handling tabs to begin to release dressing from skin. This is the American ICD-10-CM version of S31. Pressure ulcers, also known as pressure sores, bedsores and decubitus ulcers, are localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction. Chronic ulcer of skin, breakdown of skin; ICD-10-CM L98. To Remove Gently lift the border and use one hand to stabilize the. But if it's infected, the skin around the cyst may be swollen and painful. Physical examination revealed a healthy appearing female with well-demarcated scaly pink plaques located in the gluteal cleft. This is the American ICD-10-CM version of L89. 022 Pressure ulcer of left elbow, stage 2 The 2024 edition of ICD-10-CM L89. The areas around the hips. A pressure injury develops as a result of unrelieved pressure between the sacral bone and the sitting or lying surface. To read the full article, sign in and subscribe to AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS . 1. L89. 323 ICD-10 code L89. 500 results found. 31 - other international versions of ICD-10 L02. 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. 152 is assigned. L89. L00-L08 - Infections of the skin and subcutaneous tissue. PUs located on the sacrum, coccyx and/or gluteal cleft were included in the analyses as sacral PUs. Pressure Injuries Pressure Injuries Pressure Injuries Pressure Injuries Location Shape Depth Necrosis Edges Colour A combination of moisture and friction may cause moisture lesions in skin folds, but most commonly they are present in the anal cleft. 223 became effective on October 1, 2023. This is a sign that a pressure ulcer may be forming. This is the American ICD-10-CM version of L89. L89. 302 - Pressure ulcer of unspecified buttock, stage 2. No broken areas present. To code a diagnosis of this type, you must use one of the three child codes of L89. gluteal cleft, both buttocks, and inner thighs. 313 became effective on October 1, 2023. The 2024 edition of ICD-10-CM L89. 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). Pressure ulcer, buttock. 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. was wearing was recorded. doi: 10. Pressure ulcers and leg ulcers, mainly pressure ulcers, remain a public health problem in nursing homes. DTI is really a developing expression that articulates a deviation of pressure ulcers emerging primarily as bruised or dark tissue. Glute imbalance can cause pain up and down the kinetic chain and can cause pain in both the affected limb, as well as the opposite side, according to Dr. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. 1 ). L89. Surgical debridement and antiseptic dressings were done for ulcer management. The superior gluteal nerve is responsible for innervation. 323 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. It should be included in the reconstructive algorithm for the management of sacral pressure ulcers. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. Unstageable pressure injuries are widely understood to be full-thickness pressure injuries in which the base is obscured by slough and/or eschar. 304 for Pressure ulcer of unspecified buttock, stage 4 is a medical classification as listed by WHO under the range - Diseases. L89. Pressure injuries have 4 stages, ranging from an early warning signal to the most severe: Stage 1. These lesions are also often mistakenly labeled stage 1 or stage 2 pressure ulcers/injuries. 309 Pressure ulcer of unspecified buttock, unspec. The CLP feature of the bed provides pressure distribution for the upper body. ICD-10-CM Code for Pressure ulcer of left buttock L89. Figure 24a. Correct identification of these pressure injuries can be challenging among health care professionals and, although treatments vary, débridement is key. 22 - other international versions of ICD-10 L89. 42 ICD-10 code L89. Pressure ulcers are skin or soft tissue injuries that form due to prolonged pressure exerted over specific areas of the body. Intertriginous dermatitis (ITD), also referred to as intertrigo, is an inflammatory condition that affects opposing skin surfaces and can occur anywhere on the body where two surfaces are in contact. By palpation there is no cleft wounds and conducted a literature search as a basis for presentation to conference attendees, with the goal of gaining consensus regarding guidelines for accurate classification of these wounds. It is commonly seen in the skin between the buttocks (butt. 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. 0): 573 Skin graft for skin ulcer or cellulitis with mcc; 574 Skin graft for skin ulcer or cellulitis with cc; 575 Skin graft for skin ulcer or cellulitis without cc/mcc; 592 Skin ulcers with mcc; 593 Skin ulcers with cc; 594. Jildeh. 153 may differ. L89. 309 became effective on October 1, 2021. It is the most common site of intra. 19 . Stage 2- The 3 P's! Pink, Partial, Painful! Stage 2 wounds are partial thickness and often resemble a very shallow ulcer with a reddish-pink wound bed. NURSE. ⑩ [Billable] There's more to see -- the rest of this topic is available only to subscribers. Symptoms of a pressure ulcer include: discoloured patches of skin that do not change colour when pressed – the patches are usually red on white skin, or purple or blue on black or brown skin. 322 may differ. 313 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Chronic ulcer of buttock limited to skin layer; Chronic ulcer of buttock, breakdown of skin; ICD-10-CM L98. Case: A 48-year-old female was hospitalized with severe trunk pain and bilateral necrotic gluteal wounds present for more than 1 year initially diagnosed as. Drink A Lot Of Water. The following code (s) above L89. Pressure ulcer of left buttock, stage 2. Bodily secretions. 324 is a billable ICD code used to specify a diagnosis of pressure ulcer of left buttock, stage 4. ICD-10-CM Code for Pressure ulcer of contiguous site of back, buttock and hip, stage 2 L89. Pressure ulcer has tendency to happen the skin area of bony prominence, especially in the status of prolonged immobilization. L89014 Pressure ulcer of right elbow, stage 4 L89320 Pressure ulcer of left buttock, unstageable L89016 Pressure-Induced deep tissue damage of right elbow L89323 Pressure ulcer of left buttock, stage 3 L89020 Pressure ulcer of left elbow, unstageable L89324 Pressure ulcer of left buttock, stage 4 L89023 Pressure ulcer of left elbow,. The purpose of this compendium is to describe and illustrate conditions that may mimic pressure ulcers/injuries. Subscribe to Codify by AAPC and get the code details in a flash. 321 - other international versions of ICD-10 L89. The sacrum is a large concave triangular bone at the base of the spine that is the fusion of sacral vertebrae S1-S5. categorized as a pressure injury. 82 became effective on October 1, 2023. These ulcers occur at bony areas of the body such as the ischium, greater trochanter, sacrum, heel, malleolus (lateral than medial), and occiput. 1 Histologic. 894 - other international versions of ICD-10 L89. An ulcer is a break in the skin that fails to heal in a. 411 ICD-10 code L98. Map to ⑨. They’re typically seen on the sacrum, the coccyx and the ischial tuberosities. The following code (s) above L89. L89. The above description is abbreviated. 2. 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 . Assess to confrm dressing is intact and applied correctly. Pressure ulcer of contiguous sites of back, buttock, and hip; Unstageable pressure ulcer of contiguous sites of back buttock and hip; ICD-10-CM L89. PUs were categorised as stages. Use. L89. 321 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 223 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Request a Demo 14 Day Free Trial Buy Now. 314 for Pressure ulcer of right buttock, stage 4 is a medical classification as listed by WHO under the range - Diseases of the skin and subcutaneous tissue . Objectives- Participants will: • Differentiate. 159 may differ. L89. 412 Non-pressure chronic ulcer of buttock with fat layer exposed Billable; L98. The clinical manifestations, diagnosis, and management of pilonidal disease are presented here. These codes are used. This is the American ICD-10-CM version of 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. Figure 3. )ICD-10-CM Diagnosis Codes. 1). 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 . If a pres-Gluteal cleft is the vertical partition which separates buttocks. But in SGD, ulcers are developed in lower position of gluteal cleft than pressure sore which. In buttock area, pressure ulcers are prone to occur in skin area on the sacrum, ischial tuberosity, and femoral trochanter5. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 31 may differ. gluteal cleft5 Sacral pressure ulcer prevention considerations: • Assess patient for pressure ulcer risk. 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 . Shape - Pressure ulcers are circular wounds with a regular shape limited to a single spot while moisture lesions can be different superficial spots. But in SGD, ulcers are developed in lower position of gluteal cleft than pressure sore which. Gluteal (buttock) Ischial (often incorrectly described as lower buttock or upper thigh, but usually caused by unrelieved pressure from sitting) Gluteal cleft (often see moisture damage rather than pressure damage in this area) Perianal / perineal area (often due to moisture eg. Pressure pre-ulcer skin changes limited to persistent focal edema, left hip. 323 is a valid billable ICD-10 diagnosis code for Pressure ulcer of left buttock, stage 3 . 21 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. 5%; persons with skin injury were more likely to have fecal incontinence than urinary incontinence (45. 0000532739. 322 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. 303 may differ. IAD and ITD are superficial lesions that. 311 - other international versions of ICD-10 L89. The left buttock ulcer measured 5 × 5 × 1 cm and was light red with nongranular. 3 became effective on October 1, 2023. quality of pressure ulcer care with prevention: a cost-effectiveness analysis. Applicable To. 31 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. Pressure ulcer of left buttock, stage 1. This was the first year ICD-10-CM was implemented into the HIPAA code set. 321 became effective on October 1, 2023. BILLABLE | ICD-10 from 2011 - 2016. The authors gathered clinical illustrations of gluteal cle. The above description is abbreviated. stages. A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. 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 . This is a sign that a pressure ulcer may be forming. View ICD-10 Tree. A step-by-step drawing of the surgical process. Tender areas. L98. Pressure-induced skin and soft tissue injuries are localized areas of damage to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure or pressure in combination with shear (eg, sacrum, calcaneus, ischium) ( figure 1 ). Codes marked as Billable can be used in all HIPAA-covered transactions. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. L89. During this time, you will have sutures or staples removed and may have follow-up imaging. It most commonly affects males aged 16-30 years. L89. include the gluteal cleft, coccyx, perineum, buttocks, groin, face, hands, feet and other areas. A 'billable code' is detailed. 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. -) 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. 75-year-old man with a pressure ulcer clinically. The 2024 edition of ICD-10-CM L89. Reconstruction of the ischial ulcer with gluteal muscle flap and posterior thigh. Approximate Synonyms. 309 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. Code History. Mepilex ® Border Sacrum all-in-one dressing is the only five-layer foam sacral dressing with proprietary Deep Defense Technology ® – proven to prevent pressure ulcers when used in conjunction with other standard prevention protocols . This is the American ICD-10-CM version of S31. • Bone/tendon is . 92 may differ. 313 - Pressure ulcer of right buttock, stage 3 answers are found in the ICD-10-CM powered by Unbound Medicine. Stage 2. Pressure sores are grouped by the severity of symptoms. ) ICD-10-CM Diagnosis Codes. 32 - Furuncle of buttock. 7%. 153 - other international versions of ICD-10 L89. This is the American ICD-10-CM version of L89. viral warts ( B07. Pressure ulcer (L89) Pressure ulcer of left buttock, unstageable (L89. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). The vertical line starts from sacrum to the perineum. 324 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Previously, these wounds were described in the literature as ‘malignant lesions,’ closed pressure ulcers, and purple pressure ulcers. hidden1. 418 ICD-10 code L98. A reddened, sore skin on the crack of your buttocks could be a symptom of pilonidal sinus disease (PNS). 2. Keywords: gluteal flap, fasciocutaneous flap, myocutaneous. To provide pressure ulcer prevention and practice change education to 80 percent of nursing and Patient Care Assistant (PCA) staff;. L89. ICD-10 code L89. Not usually over a bony prominence. L89. 524 became effective on October 1, 2023. 9] Findings: The skin looks macerated directly in the midline, this is the upper sacrum and the lowermost extent is about 3 fingerbreadths from. The ICD code L89 is used to code Pressure ulcer. 819A - other international versions of ICD-10. images show a focal region of STIR hyperintensity along the superior gluteal cleft, in the subcutaneous fat, and overlying the coccyx (arrow), consistent with a pilonidal cyst. 45 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Pilonidal disease is a common condition of the skin and subcutaneous tissue at or near the upper part of the natal cleft of the buttocks. Figure 3: Superficial muscles of the gluteal region and posterior thigh. Decubitis ulcers often occur on the skin covering bony areas. 8; 95% CI 1. 3 - other international versions of ICD-10 L89. L89. L89. This is the American ICD-10-CM version of L89. This search was based on the key terms "surface anatomy," "skin," "buttocks," and "gluteal area. 22 became effective on October 1, 2023. 2. of gluteal cleft, with dressing ‘base’ positioned to cover coccyx area.