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Home Health ICD-9/ICD-10 Alert

READER QUESTIONS:

Know When to Reverse Stage Ulcers

Published on Fri Feb 20, 2009

Question: Can you change the stage of healing stage I & II pressure ulcers on OASIS? I know that you never change stage III & IV pressure ulcers. Do coding guidelines allow reverse staging?

North Carolina Subscriber

Answer: Stage 1 and 2 pressure ulcers are not reverse staged while healing, but once healed are considered gone and are no longer marked on OASIS as pressure ulcers. Stage 3 and 4 pressure ulcers are never reverse staged and are considered present even when healed.

Coding guidelines specify to code the stage with a code from the subcategory (707.2x) after the location (707.0x). However, coding guidelines also say that if a patient is admitted with healed stage 3 or 4 pressure ulcers, the pressure ulcers shouldn't be coded. Coders and clinicians alike should note that OASIS guidelines and pressure ulcer guidelines are not congruent as regards marking pressure ulcers on OASIS and coding pressure ulcers in the diagnoses.

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