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

[Q&A ADDED 08/07; Previously CMS OCCB 05/07 Q&A #21]
Q105.9. M1340. Is a PICC placed by a physician under fluoroscopy and sutured in
place considered a surgical wound? It would seem that placement by this
procedure is similar to other central lines and would be considered a surgical
wound.
A105.9. Even though the physician utilized fluoroscopy to insert the peripherally inserted
central catheter (PICC) and sutured it in place, it is not a surgical wound, as PICC lines
are excluded as surgical wounds for OASIS data collection purposes.
[Q&A EDITED 09/09; ADDED 08/07; Previously CMS OCCB 07/07 Q&A #8]
Q105.10. M1340. If a surgical wound is completely covered with steri-strips is it
considered non observable?
A105.10. Chapter 3 of the OASIS-C Guidance Manual states, "A [surgical] wound is
considered not observable if it is covered by a dressing (or cast) which is not to be
removed, per physician's order." Although unusual, if the steri-strip placement did not
allow sufficient visualization of the incision, and if the physician provided specific orders
for the steri-strips to not be removed, then the wound would be considered not
observable. However, a surgical wound with steri-strips should be considered
observable in the absence of physician orders to not remove strips for assessment, or if
usual placement allows sufficient visualization of the surgical incision to allow
observation of clinical features necessary to determine the surgical wound’s healing
status (e.g., incisional approximation, degree of epithelialization, incisional necrosis
(scab), and/or signs or symptoms of infection).
[Q&A ADDED 08/07; M item number updated 09/09; Previously CMS OCCB 07/07 Q&A
#9]
Q105.11. M1340. Is a heart cath site (femoral) considered a surgical wound? If
not, what if a stent is placed?
A105.11. If a cardiac catheterization was performed via a puncture with a needle into the
femoral artery, the catheter insertion site is not reported as a surgical wound for M1340.
The fact that a stent was placed does not have an impact.
[Q&A ADDED & EDITED 09/09; Previously CMS OCCB 10/07 Q&A #17]
Q105.12. M1340. If a drain was placed post-op and removed prior to admission to
home health is the drain site considered a surgical wound upon admission to
home care?
A105.12. A wound with a drain is reported as a surgical wound at M1340. It remains a
surgical wound after the drain is pulled until re-epithelialization has been present for
approximately 30 days at which time it becomes a scar.
[Q&A ADDED & EDITED 09/09; Previously CMS OCCB 10/07 Q&A #19]
Q105.13. M1340. A patient had a skin cancer lesion removed in a doctor's office
with a few sutures to close the wound. Is this considered a surgical wound?
A105.13. A shave, punch or excisional biopsy, utilized to remove and/or diagnose skin
lesions, does result in a surgical wound. It is considered a surgical wound until re-
Category 4 – OASIS Data Set – Forms and Items 09/09