Posts tagged ‘m1312’

April 24, 2012

Mucosal membranes are not reported in OASIS

CMS recently stated that only wounds and lesions of the integumentary system are recorded in OASIS, not wound or lesions in mucosal membranes.

Those pressure ulcers are reported in the comprehensive assessment and documentation.

Want to see the clarification? Go to the April 2012 link.

January 4, 2011

V58.73 is the code for cardiac catheterization with a stent

How do you code a cardiac catheterization with a stent? Aftercare? V55?

A cardiac catheterization is not considered an ostomy, so do not use V55 codes. V55 codes are not used for temporary ostomies. i.e., openings, because V55 deals with permanent placements. Use V58.73 for aftercare of the circulatory surgery. A cardiac catheterization by cut down is considered a surgical wound so mark the surgical wound questions (M1340 and M1342) appropriately for status of healing on the OASIS. A cardiac catheterization by needle puncture is not a surgical wound so make sure to mark M1350 as yes. M1350 deals with a skin lesion or open wound that excludes ostomy or other wounds addressed in the M1300s of OASIS.

The instructions at M1350 state: Ostomies, other than bowel ostomies, (e.g., tracheostomy, thoracostomy, urostomy) ARE considered to be skin lesions or open wounds if clinical interventions (e.g., cleansing, dressing changes) are being provided by the home health agency during the home health care episode.

The other items that would be excluded from M1350: Pressure Ulcers or risk of pressure ulcers (M1300, M1302, M1306, M1307. M1308, M1310, M1312, M1314, M1320, M1322, M1324), stasis ulcers (M1330, M1332, M1334), surgical wounds (M1340, M1342).

October 3, 2010

New code year … new chance for education!

As we start our new code year, we’re always scrambling for education on codes, but what about other subjects, like PPS fundamentals or OASIS best practices or coding and filling out OASIS information on those pressure ulcers?

It’s time for new education in the new year, and I’m offering these in the month of October, in addition to my live education around the country.

PPS Fundamentals, Monday, October 11
Understand the fundamentals of PPS that are essential to agency operations for administrators, quality personnel and coders. This includes information on:

  • How the HHRG is obtained.
  • Explain the case mix variable table.
  • Identifying how to bill non-routine supplies.
  • Explaining the role of diagnosis coding and OASIS answers to the financial health of a home health agency.

12pm -1:45pm CST

OASIS C Best Practices, Monday, October 18
What is a “best practice”? And what does it mean to your agency? The first quality reports have been released from OASIS C. How did CMS derive the information and how can your agency do better next time? In this education, we will:

  • Define best practice.
  • Discuss best practices involved in pain assessment, falls risk, depression screening and others.
  • Identify the correct method for answering OASIS data items regarding best practices.

12pm -1:45pm CST

Pressure ulcers, coding and OASIS-C, Monday, October 25
Coding pressure ulcers and responding to OASIS data items regarding pressure ulcers are some of the most difficult areas of home health practice. Lisa will lead your staff through the latest guidance on answering OASIS-C regarding pressure ulcers and contrast that with coding guidance. Lisa will:

  • Describe how to answer OASIS and code for pressure ulcers with skin grafts.
  • Describe how to answer OASIS and code for pressure ulcers with muscle flaps.
  • Describe how to answer OASIS and code for pressure ulcers that “heal.”

12pm -1:45pm CST

Want more information?

July 26, 2010

Pressure ulcer answers!

I always get questions during and after education seminars. Here are a few dealing with one of our favorite home health questions: pressure ulcers

Is a reddened coccyx with a few scabbed areas considered a Stage 2 because of the scabs?

Lisa says:  A Stage 1 has intact skin. The presence of scabs would be considered more than Stage 1; however, it cannot be staged if the wound bed is not visible.

If we have a Stage 3 that is closed and would be a Stage 3 on admit and discharge, do we put zeros for MO1310 1312 and 1314 to reflect that it is closed.

Lisa says: A closed Stage 3 is never fully healed, so will continue to be called a Stage 3 at each time point unless it breaks down and becomes a Stage 4. The correct response to M1310,1312 and 1314 is 000.

If a patient went in hospital for shoulder surgery and was kept in observation and left just shy of 24 hours, would the admission MO1000 be NA ?

Lisa says: This patient would still be marked ‘Hospital’ as M1000 is not related to the criteria for a transfer assessment. The item simply asks from which facility was the patient discharged. (A transfer assessment  is not required.) Note: Before you mark ‘Hospital,’ make sure this patient was not considered outpatient, e.g., had outpatient surgery.

July 22, 2010

Quick news: CMS answers OASIS questions

I’ll have some thoughts on these answers later, but just wanted everyone to know that CMS has released its quarterly Q&As to clarify OASIS issues.

Here are some highlights:

  • Pressure ulcers (M1306, M1308, M1310, M1312, M1314, M1320, M1324): responses on sutured and grafted ulcers, as well as responding for resolved suspected DTI
  • Measuring the depth of ulcers
  • M1510 heart failure followup issues
  • Other issues dealing with M102, M104, M1012

See the responses here.

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