CMS in its latest quarterly OASIS Q&As provided agencies with details about how to code a specific wound scenario.
In Question 1 of the April Q&As, one agency asked CMS about a patient admitted with two distinct areas caused by pressure.
Notes the agency: “A wound on the left buttock presents with purple localized discolored skin, tenderness with blistering and superficial open areas in the wound center. A second wound on the right buttock presents with boggy, purple/maroon localized discolored skin with a full-thickness Stage 3 pressure ulcer in the wound center. Both appear as evolving deep tissue injuries (DTIs) but since DTIs are described as intact skin, and neither of these are intact, we do not know how to code these at SOC.”
In its response, CMS states: “A pressure wound presenting with characteristics of a DTI is reported as a DTI unless full thickness tissue loss is present. The pressure wound on the left buttock presents with characteristics of a DTI (purple localized discoloration with tenderness caused by pressure), but without full thickness tissue loss. This wound would be coded as a DTI, even though the wound is not completely intact. The pressure wound on the right buttock presents with characteristics of a DTI (bogginess, purple/maroon localized discoloration caused by pressure), and with full thickness tissue loss. This wound would be coded as a Stage 3 pressure ulcer.”
View the quarterly Q&As at https://qtso.cms.gov/system/files/qtso/CMS_OAI_1st_Qtr_2019_QAs_April%202019%20Final_508.pdf.