OASIS-Central

Q: The skin lesion or open wound data element (M0440) was always one of the most confusing. Has there been a change to make it clearer?

A: In OASIS-B1, M0440, asked whether the patient had a lesion or open wound. The definition of a lesion is broad, including any area of pathologically altered tissue, with the exception of ostomies and peripheral IV sites. Anything from a freckle, mole, or a scar to dandruff, rash, or edema constitutes a lesion. It’s likely every person has at least one skin abnormality

The confusion with that element was created by one instruction. “If the patient has any skin condition which should be observed and described, mark ‘Yes’ to this item.” That led some clinicians to believe that if the lesion did not merit observation, the answer should be “No.” However, the intent of the data element was to find out whether the patient had a lesion, whether it needed to be observed or not.

OASIS-C finally replaces a seemingly useless question with one that provides some insight for care planning. The new data element, M1350, asks about any lesion or open wound that requires observation or care. This will ensure that lesions or wounds that require attention are reported. On OASIS-B1 you were asked to report any lesion or wound; now, only ones that require observation or care.