Are you prepared for OASIS D? If so, great work! If not, read on.
Starting with M1306, OASIS D was revised to include the terminology Unhealed Pressure Ulcer/Injury at Stage 2 or Higher when describing wounds…(M1306) Does this patient have at least one Unhealed Pressure Ulcer/Injury at Stage 2 or Higher or designated as unstageable? (Excludes Stage 1 pressure injuries and all healed Stage 2 pressure ulcers/injuries). M1306 time points for use include, SOC, ROC, follow-up and DC.
What does the new terminology “injury” mean?
According to the National Pressure Ulcer Advisory Panel (NPUAP), “a pressure injury is a localized damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device. The injury can present as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, co-morbidities and condition of the soft tissue.”
CMS has adapted the NPUAP terminology and guidelines for home health and other post-acute care settings’ purposes. A Stage 1 is termed an “injury” while Stage 2, Stage 3 and Stage 4 are termed “ulcers”. A deep tissue injury continues to be termed an injury. Classification of unstageable due to slough and/or eschar is a pressure ulcer. Classification of unstageable due to non-removable dressing/device as ulcer or injury is not possible, until that point at which it becomes visible. Thus, these are referred to as ulcers/injuries.
Please note that the CMS definition is different from the National Pressure Ulcer Advisory Panel; therefore, your OASIS answer might be different than your nursing wound documentation.
This answer is intended to provide guidance on OASIS questions that were received by CMS help desks. Responses contained in this document may be time-limited and may be superseded by guidance published by CMS at a later date.
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