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
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-----Original
Message-----
From: Michelle
Witges [mailto:[EMAIL PROTECTED]
Sent: Tuesday, December 02, 2003 2:50
PM
To: [EMAIL PROTECTED]
Subject: Re: section M, coding--PLease
help a.s.a.p.
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.
----- Original Message -----
Sent:
Tuesday, December 02, 2003 12:12 PM
Subject: section
M, coding--PLease help a.s.a.p.
We are currently undergoing Medicaid
review on some of our resident’s assessments from 2002. I am in
disagreement with the reviewer on how to code in section M. Here is
the example:
A morbidly obese resident has open
sores in abdominal folds. Nurses are charting open slit to abdominal
fold. Applying nystatin and kling to abdominal folds daily.
How would you guys code this under
section m4 and m5???
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.
