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Ask the treatment expert
Ask the treatment expert
If a resident was admitted from the hospital after grafting due to a pressure ulcer on a heel, is this coded as a surgical wound on the MDS or still a pressure ulcer?

If a skin ulcer is repaired with a flap graft, it should be coded as a surgical wound and not as a skin ulcer. If the graft fails, continue to code it as a surgical wound until it is healed.

At what stage is a blood-filled blister on the heel?

For documentation in long-term care and MDS coding, this would be considered a stage II pressure ulcer. However, according to the National Pressure Ulcer staging guidelines, it is considered a deep tissue injury.

Can lower extremity wounds be classified as diabetic stasis ulcers if the resident has the diagnosis of diabetes?

A diabetic resident could have a venous insufficiency ulcer (stasis ulcer), but it would not be called a diabetic stasis ulcer, just a “venous insufficiency ulcer.”

Venous insufficiency ulcers are caused by venous hypertension, and are located on the medial lower leg, ankle and medial malleolar area. Venous hypertension can be caused by one or more factors, sometimes combined, including: compromised valve function in the vein, partial or complete obstruction of the vein (e.g. deep vein thrombosis, obesity, malignancy), and/or failure of the calf muscle to pump the blood (e.g., paralysis, decreased activity).

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