OASIS Alert
Don't Reverse Staging with Stage IV Pressure Ulcer
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Question: At start of care (SOC), my patient had a closed Stage IV pressure ulcer. When assessed two weeks later, it appeared to be a shallow open ulcer. Can I report this ulcer as Stage II or is it considered a nonobservable Stage IV pressure ulcer because I can’t visualize bone, muscle or tendon?
Answer: It’s not appropriate to reverse stage a Stage III or Stage IV pressure ulcer. If a previously closed Stage III or Stage IV pressure ulcer opens again, you should report it at its worst stage.
“As long as the wound bed is free of slough and eschar, it may be reported as a Stage IV,” the Centers for Medicare & Medicaid Services advises in the April 17, 2013 CMS Quarterly OASIS Q&As.
However, if slough or eschar obscure the wound bed, you can’t stage the pressure ulcer. In this case, you would report it in M1308 — Current Number of Unhealed (non epithelialized) Pressure Ulcers at Each Stage as “d.2 — Known or likely but unstageable due to coverage of wound bed by slough and/or eschar.”
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Don't Reverse Staging with Stage IV Pressure Ulcer
Question: At start of care (SOC), my patient had a closed Stage IV pressure ulcer. [...]