Patti, I work on a Quality team in homecare. We have an Oasis "guru" of sorts named Beacon Health....they tell us anything from a mole, old scar, even a freckle or dandruff constitutes a skin lesion. We have all our nurses answer M0440 yes for any of the above items noted during assessment. It tacks on a point or two for the HHRG total score. I know it seems ridiculous that any of these items would be considered a skin lesion, but we're talking about the government and it's regulation of healthcare!! :chuckle