How to Answer M1313 – Worsening in Pressure Ulcer Status since SOC/ROC
This month we will discuss M1313, Worsening in Pressure ulcer status since SOC/ROC. This item is only answered on the discharge OASIS and reports the number of current stage 2, 3 or 4 or unstageable pressure ulcers that are new or have worsened in stage since the most recent SOC or ROC. The current stage at discharge should be compared to past stages to determine whether the pressure ulcer currently present is new or at an increased numerical stage (worsened) when compared to the most recent SOC/ROC
- If the pressure ulcer was unstageable at the SOC/ROC, but becomes numerically stageable later, the “present on admission” stage should be considered the stage at which it first becomes numerically stageable. You may remember this guidance from last month’s coding tip about M1311.
- If a pressure ulcer increased in numerical stage from SOC/ROC to discharge, it is considered worsened and would be included in the counts of worsened pressure ulcers and reported in this item.
- Pressure ulcers that are covered with a non-removable dressing at discharge cannot be staged. It will only be reported in M1313 if it was not present at the most recent SOC/ROC.
- Pressure ulcers that are unstageable due to eschar and/or slough will only be reported in M1313 if it was a stage 1 or 2 at the most recent SOC/ROC. If it was a stage 3 or 4 at the most recent SOC/ROC it should not be considered worsened and therefore will not be reported in M1313.
- If at discharge the patient has a DTI which is unstageable, it will only be reported in M1313 if it was a stage 1 or 2 or not present at all on the most recent SOC/ROC.
There are several more scenarios outlining more complex situations and a reporting algorithm for this item in Chapter 3 of the OASIS Guidance Manual. Each clinician completing discharge OASIS should have a copy of this algorithm. It is very important that you refer to the item-by-item guidance when questions arise.