How do you code stasis ulcers?

[Rizpah]

We just admitted a resident that has some problems with skin integrity on his lower extremities. I believe the ulcers were the result of edema and weeping tissue, so I'm planning on coding them as stasis ulcers. On his right leg there are a couple of very defined areas and I'll be able to count them. But on his left leg, it looks like they all just kind of run together. How would you guys code that? As one large one if there are no definite lines between any of the areas? Then as areas heal start counting out spots? I've not had a case like this to code up until this point and could sure use some advice. The MDS manual doesn't give any good examples that fit this instance.

Thanks in advance!

God bless!

[Talino]

The ulcers may be coded in M1 but don't rush yet to code it in M2 as stasis ulcers. Confirm if resident has a diagnosis of circulatory problems. In a weeping edema, there is a back up of pressure within the small veins and small arteries (capillaries). A venous ulcer may be coded in M2 (Stasis) but not an arterial ulcer.

This is a good guide in identifying leg ulcers, http://www.wocn.org/publications/facts/pdf/C_QUICK1.pdf then have the MD confirm the type of ulcer. Unless the origin can be determined, it may not necessarily be the correct diagnosis. Until validated, the clinicians will address it as such.

The description of the affected areas on the left leg seem to fit the definition in M4d rather than M1 or M2. Maybe even a stasis dermatitis.

[Rizpah]

Talino, thank you so much! The reference you sent is awsome and I appreciate the input! You're an angel!