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Wow, Linda
This is quite interesting, to say the least. Which
state are you in? I have someone on one of my units that developed
several stage 3 areas from skin tears and/or abrasions. She had PVD, and I did
manage to get an MD progress note stating that the wounds were secondary to
stasis and thus coded as stasis ulcers.
I realize that your appeal was denied, but it might
be worth the validation to write or email to someone at NPUAP. The website
is www.npuap.org Dr
Courtney Lyder, who presented on pressure ulcers at the Las Vegas conference has
been very approachable and helpful to me on a couple of issues that have arisen.
There is an email link for him on the website.
Good luck.
Holly
----- Original Message -----
Sent: Tuesday, November 18, 2003 2:17
PM
Subject: MDS coding in M section
I recently had an appeal with the state department
on my coding of the MDS. I have a resident who received treatment to 2 open
areas on her legs for about 6 weeks. These areas started as skin tears that
were repaired with steri strips but later became open lesions. Because they
started as skin tears the State said I could not count them as open lesions
nor could I stage them on the MDS. My question is: how can an area continue to
be called a skin tear when it now is open, with the skin and tissue gone and
is at a stage 2? I also felt when an area required treatment for 6 weeks
before it healed it is more than a skin tear. I lost my appeal. I view this as
unfair as the facility does not get any credit for doing treatments when it is
classified a skin tear. What are others thoughts on this? I also felt I was
correct in my coding as the manual states open lesions/sores are skin ulcers
that may develop because of injury. Isn't a skin tear an injury? I would
appreciate others opinon and experience regarding this.
Linda Fuchs
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