OASIS Alert

Can you conquer these surgical wound coding conundrums?

Surgical wound coding can be complicated at best and confusing at worst.

You can keep your wound coding know-how up to snuff with sample scenarios that help you stay on top of the game.

Here are a few examples:

Scenario #1: A physician aspirates your patient's joint. The procedure leaves behind a small puncture area. Would you report this area as a surgical wound?

Solution: If a needle was inserted simply to aspirate fluid, but was then removed without leaving a drain or other object in its place, the site should not be reported as a surgical wound, according to the Centers for Medicare & Medicaid Services in the April 2008 set of OASIS questions and answers posted on the OASIS Certificate & Competency Board's Web site.

Scenario #2: Your patient suffers from constant joint swelling and pain. A physician uses a drain to fully aspirate the area. Should the wound that drain leaves behind be reported as a surgical wound?

Solution: When a surgical procedure creates a wound in which a drain is placed (e.g., an incision or stab wound), the presence of the drain (or drain wound site until healed) should be reported as a surgical wound, OCCB reports.

Scenario #3: A physician uses arth-roscopy to fully diagnose and treat your patient's chronic joint pain. Should the site of the procedure be reported as a surgical wound?

Solution: If a physician uses arthro-scopy to perform a surgical procedure, the arthrocentesis site would be considered a surgical wound until it heals and becomes a scar/lesion.

Next step: You should develop a list of sample scenarios that best fit your home health workers' areas of confusion or inconsistency. That way, you can provide practical training while reinforcing your agency's rules.