Posts tagged ‘WOCN’

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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June 14, 2010

OASIS and Unstageable Pressure Ulcers

I receive a lot of questions on pressure ulcers, especially with all of the new OASIS specificity. One of the most common questions deals with  eschar covering the wound.

This type of question has a common theme: If the wound is covered in soft/brown eschar on assessment (it had been documented as a Stage III ulcer), should it be coded as unstageable? And what about M1314, the pressure ulcer depth?

My answer is that a pressure ulcer with eschar can’t have depth; it’s 0 (zero)  because it is covered. You can still measure the length and width, so M1310 and M1312 are straightforward.

Your healing status for M1320 is 3-Not Healing.
The answer to this question is NOT NA- No Observable Pressure Ulcer

Remember WOCN guidance on answering M1320  3 – Not healing:
o wound with ≥25% avascular tissue (eschar and/or slough) OR
o signs/symptoms of infection OR
o clean but non-granulating wound bed OR
o closed/hyperkeratotic wound edges OR
o persistent failure to improve despite appropriate comprehensive wound management

As for M1324, the answer is NA because the pressure ulcer cannot be staged because the wound bed is not visible.

Looking for the full WOCN guidance? We have it here.