For answer to MO440, does this patient have a skin lesion or an open wound, is you look at the guidance in Chapter 8 of the OASIS implementation manual, CMS considers the following lesions: "A lesopm is a broad term used to describe an area of pathologically altered tissue. Sores, skin tears, burns, ulcers, rashes, surgical incisions, crusts, etc. are all considered lesions. All alterations in skin intergrity are considered to be lesions, except alterations ending in ostomy...or peripheral IV sites. Persisitent redness without a break in the skin is also condisered a lesion." Under Tips: " a skin lesion is an area of pathologically altered tissue - primay lesions i.e. vesicles, pustules, wheals; secondary lesions - i.e. crusts, ulcers, scars; Changes in color of texture such as maceration, scale, lichenificaiton; Changes in shape of skin surface such as edema, cyst, nodule; breadks in skin surfaces such as abrasion, excoriation, fissure, incision; Vascular lesion such as petechiae, eccymosis. It includes but is not limited to: wounds, ulcers rashes, crusts, bruises, sores, skin tears, burns, surgical incions, pin sites, wounds with staples or sutures, central lines, PICC lines, prtacath, mediport, implanted infusion devises, venous access devices, current surgical wound or healed scar of pacemeker insertion, scars, femoral puncture site resulting from heart catheterization. "
Almost all patients of a certain age have a skin lesion as described, moles, freckles, age spots all count.
As to why she calls you on your day off, the OASIS must be done and transmitted before your agency can bill for the RAP - if you donot answer all questions or there are questions regarding consistency within the OASIS document itself, it directly affects payment and depending on how your agency is set up, they could bill the raps daily to ensure enough cash flow so that you get a paycheck.
If you haven't already, please get a copy of chaper 8 from the OASIS implementation manual - it answers each OASIS MO question. You must learn to speak OASIS speak, which is entirely different than clinical nursing.