Home Health ICD-9/ICD-10 Alert

Question: I have read that stage III and stage IV ulcers should remain on the patient's chart even after they have closed. The rationale behind this seems reasonable. But if we cannot duplicate codes on a record and must sequence the stage directly after the ulcer's location, what would be the proper way to code the following scenario:

Answer: Code for this patient as follows:

M1020a: 707.04 (Pressure ulcer, hip);

M1022b: 707.05 (Pressure ulcer, buttock);

M1022c: 707.23 (Pressure ulcer, stage III); and

M1022d: 707.22 (Pressure ulcer, stage II).

As mentioned in the previous reader question, the coding guidelines do not address what to do when multiple locations have the same stage pressure ulcer. But the same code cannot be coded more than once. Closed stage III and stage IV pressure ulcers are never fully healed and require continued active intervention.