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Here is the funny thing. I was told by the Medicaid reviewer that you can only code “open lesion/sores” if it is a open lesion from syphyllis or cancerous lesion. I guess I’ve always coded open lesion/sores if it is not a skin tear, not an abrasion or rash then it seems to fit in the “open lesions/other category” . Am I wrong???? I coded this resident as having an open lesion in her abdominal fold. Her contributing factors were her diabetes and obesity---in other words diagnosis linked to her developing the open “sore”. I don’t know how to win this one. She is coded it down so therefore we lose $$$ for three months. Any advise, suggestions, comments appreciated.
Heidi Ebertowski,R.N. MDS Care Coordinator Valley Memorial Homes Grand Forks, ND (701)787-7937 fax (701)787-7901 Confidentiality Statement: This message is intended for the sole use of the individual and entity to whom it is addressed, and may contain information that is privileged,confidential and exempt from disclosure under applicable law. If you are not the intended addressee,nor authorized to receive for the intended addressee,you are hereby notified that you may not use,copy,disclose or distribute to anyone the message or any information contained in the message. If you have received this message in error,please immediately advise the sender by reply email and delete the message. Thank you. -----Original
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I would code as a rash and other open lesions, as there is an actual break in the skin. I would also code medication and dressing. Michelle
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