MDS Alert

RAI Manual update provides better explanation of M1040.

Although the latest changes to the MDS 3.0 RAI Manual may seem overwhelming, many of the revisions and additions are actually extremely helpful.

Case in point: In Section M1040: Other Ulcers, Wounds and Skin Problems,the Centers for Medicare & Medicaid Services (CMS) adds these new coding examples:

Scenario: Mrs. J. was reaching over to get a magazine off of her bedside table and sustained a skin tear on her wrist from the edge of the table when she pulled the magazine back towards her.

• Coding: Check M1040G, Skin Tear(s).
• Rationale: The resident sustained a skin tear while reaching for a magazine.

Scenario: Mr. S., who is incontinent, is noted to have a large, red and excoriated area on his buttocks and interior thighs with serious exudate which is starting to cause skin glistening.

• Coding: Check M1040H, Moisture Associated Skin Damage (MASD).
• Rationale: Mr. S. skin assessment reveals characteristics of incontinence-associated dermatitis.

Scenario: Mrs. F. complained of discomfort of her right great toe and when her stocking and shoe were removed, her toe was red, inflamed and had pus draining from the edge of her nail bed. The podiatrist determined that Mrs. F. has an infected ingrown toenail.

• Coding: Check M1040A, Infection of the foot.
• Rationale: Mrs. F. has an infected right great toe due to an ingrown toenail.

Scenario: Mr. G. has bullous pemphigoid and requires the application of sterile dressings to the open and weeping blistered areas.

• Coding: Check M1040D, Open lesion other than ulcers, rashes, cuts.
• Rationale: Mr. G. has open bullous pemphigoid blisters.

Scenario: Mrs. A. was just admitted to the nursing home from the hospital burn unit after sustaining second and third degree burns in a house fire. She is here for continued treatment of her burns and for rehabilitative therapy.

• Coding: Check M1040F, Burns (second or third degree).
• Rationale: Mrs. A. has second and third degree burns, therefore, burns (second or third degree) should be checked.

Source: MDS 3.0 RAI Manual v1.10.