Home Health ICD-9/ICD-10 Alert

Absence of healing ridge no longer indicates nonhealing surgical wound.

A change to wound assessment guidelines means you will have to change your coding for surgical wounds -- and lose 15 points.

One of the biggest changes to OASIS is in the revision of the Wound Ostomy and Continence Nurses Society (WOCN) document on status of wound healing in surgical wounds. The presence or absence of the healing ridge is no longer considered clinically valid as an indicator of wound healing status.

Old way: The signs of a nonhealing wound were incisional separation, incisional necrosis, signs and symptoms of infection and no healing ridge. A new surgical wound will not have a healing ridge, so it met the criteria for nonhealing wound, says Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, consultant and principal of Selman-Holman & Associates in Denton, TX. This meant that the wound could accurately be coded as a nonhealing surgical wound (998.83), and M0488 could be answered "not healing" for 15 points, she says.

New way: Now that the healing ridge has been removed from the criteria, only a surgical wound with incisional separation, incisional necrosis or signs and symptoms of infection can be regarded as nonhealing. A new surgical wound not meeting those criteria would be marked as early/partial granulation on OASIS and should be coded with the appropriate aftercare code, not 998.83, Selman-Holman says. 

Note: Read the WOCN document here: www.oasisanswers.com/downloads/WOCNOASISguidanceRev072406.pdf.