stasis vs.pressure

[dianediane90]

Have a resident admitted in March --staff documented pressure area on ankle which she had on admission stage two area---I can't remember looking at the area but feel I did---counted pressure area on 5 day,14 day,30 day and 60 day---for her 60 day the PA saw her and documented chronic stasis area for her stage two area on inner ankle that I counted as pressure--she did see her and documented that on her ARD for 60 day but her progress note was not available till few days later---the resident is now open for a quarterly 6-14-16--she was seen 6-10-16 and PA still document chronic stasis area---feel like I should change this to a stasis area??? if I put in stasis area ,question comes up for "was there a pressure area on last assessment"--should I keep coding pressure??? should I correct the 60 day???she does have dx PVD--she is to see a vascular doctor on 7-5-16---doesn't help me with this assessment---this is confusing I know and thank you ahead of time

[Talino]

Was there a physician statement that the area was a pressure ulcer when captured in the prior MDSs? If it was solely based on a "nursing assessment", the PA's current diagnosis supersedes the previous finding. You will need to correct (modify) all MDSs that were miscoded as pressure ulcer.

[NurseMellie]

That is certainly tricky. It may be both a stasis ulcer and a pressure ulcer. As Talino mentioned if there is no documentation for the previous MDS from the MD, and you have just based it on nursing judgement, it would be stasis.