OASIS Alert

Don’t make this common M1308 mistake.

OASIS item M1308 is getting a much anticipated make over in OASIS-C1. But you still need to know how to respond to this confusing item between now and the transition date. Try your hand at the following scenarios to see if your approach needs some fine-tuning.

Know these M1308 Basics

OASIS item M1308 is composed of two columns used to report Stage II or higher or unstageable pressure ulcers.

Column 1: Report the number of pressure ulcers at each stage (or those that are unstageable) at the time of the current assessment.

Column 2: Report the number of pressure ulcers listed in Column 1 that are still present.

Hint: The number of pressure ulcers you report in Column 2 should never be greater than the number you list in Column 1.

Remember, M1308 only applies to Stage II, Stage III, Stage IV, and unstageable ulcers.

Can You Choose the Right M1308 Response?

Now that you’ve had a refresher on the rules for answering M1308, try choosing the right responses in the following scenarios.

Question 1: At admission, your patient had a Stage III pressure ulcer on his buttock. That same pressure ulcer is assessed as a Stage IV at Recert. How would you answer M1308 for this patient at SOC? How would you answer M1308 at Recert?

Answer 1: At SOC, you’ll report one Stage III pressure ulcer in Column 1, row b for this patient. Leave Column 2 blank. Column 1 asks you to record the current number of unhealed Stage II, Stage III, Stage IV, and unstageable pressure ulcers. You’ll complete this column at start of care (SOC), resumption of care (ROC), follow-up (FU), and discharge (DC).

At Recert, you’ll report one Stage IV pressure ulcer in Column 1, row c, and one Stage IV pressure ulcer in Column 2, row c. Column 2 asks you to indicate the number of pressure ulcers listed in Column 1 that were present at the most recent SOC or ROC — even if the stage has changed. You’ll complete Column 2 at FU, and DC.

Question 2: Your patient comes home from the hospital with a Stage II pressure ulcer on his heel. How would you answer M1308 for this patient at SOC? At Recert this pressure ulcer has developed into a Stage III pressure ulcer. How would you answer M1308 at Recert?

Answer 2: At SOC, you’ll only answer Column 1, says Ann Giles, RN, BSN, HCS-D, COS-C director of coding & OASIS review services for Biloxi, Miss.-based PPS Plus Software. For this patient, you’ll report one stage II pressure ulcer in Column 1, row a.

At Recert, you’ll report one stage III pressure ulcer in Column 1, row b, and one stage III pressure ulcer in Column 2, row b.

When completing M1308 at SOC, ROC, FU, and DC, clinicians often want to report the stage of the pressure ulcer at the last SOC or ROC in Column 2, Giles says. But that’s not what Column 2 is asking. You’re reporting the number of current pressure ulcers that were present at SOC or ROC in Column 2. Column 2 has nothing to do with what stage the pressure ulcer was at SOC or ROC, she explains.

Question 3: Your patient has no pressure ulcers at SOC. At Recert, he has a Stage II pressure ulcer on his hip. How would you answer M1308 at SOC? At Recert?

Answer 3: At SOC, you would answer “0” for all rows in Column 1 for this patient.

At Recert, you would report one pressure ulcer in Column 1, row a. In Column 2, you would answer row a with “0” because the Stage II pressure ulcer wasn’t present on admission.

Question 4: Your patient has a Stage II pressure ulcer on her hip at SOC. By discharge, that ulcer has become a stage III. How would you respond to M1308 at discharge for this patient?

Answer 4: You’ll report one Stage III pressure ulcer in Column 1, row b and one Stage III in column 2, row b. The patient’s pressure ulcer was present at SOC, even though it has progressed from Stage II to Stage III.

When completing M1308 at discharge, Column 1 documents the current number of pressure ulcers present and Column 2 shows whether that same ulcer was also present at the most recent SOC or ROC.

Question 5: Your patient has a Stage I pressure ulcer at SOC. By Recert, it has become a Stage II. How would you answer M1308 at SOC? How would you answer M1308 at Recert?

Answer 5: Stage I pressure ulcers are not reported in M1308, Giles says. For this patient, you would answer “0” for all rows in Column 1 at SOC. You would report the Stage I pressure ulcer in M1322 —Current Number of stage I Pressure Ulcers.

At Recert you would report one Stage II pressure ulcer in M1308 Column 1, row a, and one Stage II pressure ulcer in Column 2, row a.