Q:
Are wounds not otherwise classified on the MDS supposed to be coded at M1040D. Open lesion(s) other than ulcers, rashes, cuts?
A:
Accurate coding of skin conditions on the MDS must begin with determining the underlying cause (etiology) of the skin issue. Keep in mind that not all skin conditions are captured on the MDS assessment—for example, rashes, abrasions, and lacerations are not coded but should still be addressed in the plan of care.
Importantly, M1040D should not be used as a “catch-all” for skin conditions that don’t fit other coding categories. This item is intended for open lesions that develop as part of a disease or condition (RAI Manual, page M-34), and documentation should detail both the skin concern and causative factor(s).
Written By:
Eleisha Wilkes, RN, GERO-BC, RAC-CT, DNS-CT
Senior Consultant
Proactive LTC Consulting
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