pressure ulcer

mgourley@kvhealth.net

Please help. Patient with unstageable right hip decubitus, it is unstageable due to graft present. I know the code for the ulcer is L89.210, but I cannot remember how to code the graft site. Would it be aftercare following surgery to skin?

kupton@nhccare.com

See the Official Coding Guidelines for this, page 88 of the Efile 7.Aftercare at: https://www.cms.gov/medicare/coding/icd10/downloads/2016-icd-10-cm-guidelines.pdf

If the pressure ulcer was completely excised and the graft includes muscle tissue, then using the aftercare code is accurate and the unstageable ulcer would not be assigned. But, if the graft is limited to skin or subcutaneous tissue only, you will include the pressure injury code in your sequence. Have you seen the new NPUAP staging of pressure injuries? If not, here's the link: http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/



Karen Upton, RN, HCS-D, COS-C
NHC HomeCare
o: 615-890-2020 Ext. 1812
f: 615-278-3043
kupton@nhccare.com

kcarter

If you have physician documentation diagnosing them as a PU I would code them after ensuring the nurse is documenting recommendation to the patient and patient refusal. Will the patient let the nurse visualize them to stage them for the OASIS?