OASIS-Central

Q: What’s this I hear about having to report ICD-9 codes for the stages of pressure ulcers?

A: There are now two subcategories for pressure ulcers: one to identify the site (707.00-707.09) and another to describe the stage (707.20-707.25). Follow these guidelines for reporting a pressure ulcer.

• Report two codes (site) to completely describe a pressure ulcer. Report the pressure ulcer site as a primary or other diagnosis (M1020/M1022, diagnoses, lines a through f), depending on the plan of care. Then list the pressure ulcer stage as a pertinent diagnosis (lines b through f). Pressure ulcer stage cannot serve as the principal diagnosis.

• When a patient has bilateral pressure ulcers with the same documented stage, report the code for the site and one code for the stage.

• If the bilateral pressure ulcers have different stages, assign one code for the site and the appropriate codes for the stage. Even though the case-mix payment will apply to one ulcer only, sequence the ulcers in order of priority, that is, the most problematic and/or the one with the most impact on the plan of care.

• When a patient has multiple pressure ulcers at different sites such as the heel, buttock, and hip, and each pressure ulcer is at a different stage, assign the appropriate codes for each different site and a code for each different pressure ulcer stage. Follow the sequencing guidance in the previous point.

The winter audio conference series, “OASIS-C Process Measures: Best Practice Strategies to Reduce Risk,” debuts on January 21. The first session will address prevention and treatment of pressure ulcers and other wounds. Find more information at — http://www.beaconhealth.org/item–Prevention-and-Treatment-of-Pressure-Ulcers-and-Other-Wounds–J012110A.html.

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