category 4 a - oasis data set forms - Missouri Department of Health ...

A89.3. Within the context of answering OASIS Pressure Ulcer items, "directly palpable"
means visible.
Q90. [Q&A RETIRED 09/09; Duplicative of OASIS-C Guidance Manual]
Q90.1. [Q&A RETIRED 09/09; Duplicative of OASIS-C Guidance Manual]
Q91. [Q&A RETIRED 09/09; Outdated]
Q92. [Q&A RETIRED 09/09; Outdated]
Q93. [Q&A RETIRED 09/09; Duplicative of OASIS-C Guidance Manual]
Q94. M1306-M1324. If a Stage 3 pressure ulcer is closed with a muscle flap, what
is recorded? What if the muscle flap begins to break down due to pressure?
A94. If a pressure ulcer is closed with a muscle flap, the new tissue completely replaces
the pressure ulcer. In this scenario, the pressure ulcer "goes away" and is replaced by a
surgical wound. If the muscle flap healed completely, but then began to break down due
to pressure, it would be considered a new pressure ulcer. If the flap had never healed
completely, it would be considered a non-healing surgical wound.
Q95. M1306-M1324. If a pressure ulcer is debrided, does it become a surgical
wound as well as a pressure ulcer?
A95. No, as debridement is a treatment procedure applied to the pressure ulcer. The
ulcer remains a pressure ulcer, and its healing status is recorded appropriately based on
assessment.
[Q&A EDITED 09/09]
Q96. M1306-M1324. If a single pressure ulcer has partially granulated to the
surface, leaving the ulcer open in more than one area, how many pressure ulcers
are present?
A96. Only one pressure ulcer is present.
Q97. [Q&A RETIRED 09/09; Outdated]
[Q&A EDITED 08/07; ADDED 06/05]
Q98. M1306-M1324. Can a previously observable Stage 4 pressure ulcer that is now
covered with slough or eschar be categorized as Stage 4?
A98. No, a pressure ulcer that is covered with eschar cannot be staged until the wound bed
is visible. The status of the pressure ulcer needs to correspond to the visual assessment by
the skilled clinician on the date of the assessment. This is documented on the Wound,
Ostomy, and Continence Nurses (WOCN) Association website at www.wocn.org in the
WOCN Guidance Document and at the NPUAP site at www.npuap.org.
[Q&A ADDED 09/09; Previously CMS OCCB 10/08 Q&A #3]
Category 4 – OASIS Data Set – Forms and Items 09/09