Home Health Coding and OASIS Expert

Question: Our patient had a Stage IV pressure ulcer that became infected during the episode. At discharge, for M1309: Worsening in Pressure Ulcer Status since SOC/ROC can we consider the new infection a “worsening” of the pressure ulcer?

Answer: “Don’t try to use a clinical definition of worsening” when answering M1309, said Linda Krulish, PT, MHS, COS-C, president of Redmond, Wash.-based OASIS Answers during the Sept. 3 Centers for Medicare & Medicaid Services OASIS-C1 implementation webinar.

The only definition of “worsening” you should use when answering M1309 is an increase in numerical stage, the Centers for Medicare & Medicaid Services said in the July 2014 OASIS Q&As.

For example: If your patient’s Stage 3 pressure ulcer worsened or progressed to a Stage 4 pressure ulcer, you would count it as worsening when completing M1309.

“‘Worsening,’ as defined by M1309, does not take into consideration other aspects of the pressure ulcer, like changes in healing status due to a new infection, or increased pain intensity at DC, compared with SOC,” CMS said.

Read all of the July 2014 OASIS Q&As here: www.oasisanswers.com/aboutoas_links.htm. Scroll down to the OASIS Questions & Answers section and click on the July 2014 link.