You thought you knew the answers, but are you sure? Questions: A) When answering M0440 (Does this patient have a skin le-sion or an open wound?) is a tracheostomy or a thoracostomy counted? B) In M0440, does periostomal skin breakdown around an ostomy count as a skin lesion? Answers: A) No. The word from the Centers for Medicare & Medicaid Ser-vices is that tracheostomies and thoracostomies are not skin lesions or open wounds for OASIS purposes. Ignore conflicting guidance from industry listservs and from a CMS source, the agency says in January 2008 OASIS question and answer 19. B) Yes. The stoma itself is not a lesion or open wound for M0440, CMS says in OASIS Q&A 20, but an area of breakdown around the stoma, such as cellulitis or ulceration, would be considered a lesion. Note: OASIS Q&As for Jan. 2008 are at http://www.oasiscertificate.org, under "Resources."