Per coding guidelines, “confirmation” does not require documentation of positive laboratory testing specific for avian or other novel influenza A, or other identified influenza virus.Learning activities for cognitive development however, coding should be based on the provider’s diagnostic statement that the patient has avian influenza or other novel influenza A for category J09, or has another particular identified strain influenza, such as H1N1 or H3N2, but not identified as novel or variant,category J10. [1.C.10.C]

learning activities for cognitive development

When coding influenza, we must code to the highest level of specificity for the type, subtype and associated manifestations. A search in the alphabetic index should begin with the term “influenza.” if you begin with the term “flu,” the alphabetic index will instruct you to “see also influenza.” under the term “influenza,” we have choices for specific types and strains of the flu as well as codes to further specify any specific manifestations associated with influenza.Learning activities for cognitive development

Only provider-confirmed cases of avian or bird influenza, swine influenza, influenza of other animal origin, not bird or swine, or influenza A/H5N1 should be coded using the J09 category.Learning activities for cognitive development this category has a place hold X in the fourth position and requires a fifth character to specify the associated manifestations. J09.X2 is the default code for influenza due to identified novel influenza A virus NOS.Learning activities for cognitive development

J10 is the correct category for influenza due to other identified influenza viruses. If the influenza is identified as influenza A but not documented as novel, this is the correct code category.Learning activities for cognitive development use this code category when documentation identifies another particular identified strain of influenza, such as H1N1 or H3N2, but the virus is not identified as novel or variant.Learning activities for cognitive development this is also the correct category for influenza B or C.

Answer: do not "down code" or reverse stage a pressure ulcer as a way to document healing.Learning activities for cognitive development reverse staging does not accurately characterize what is physiologically occurring as the ulcer heals. Over time as the stage 4 pressure ulcer heals and contracts it becomes less deep, wide and long.Learning activities for cognitive development the tissues (muscle fat, dermis) that were lost due to the ulcer are never replaced with the same type of tissue. Even though the wound has granulated almost completely (i.E., it’s 95% granulated), the ulcer is not reverse staged.Learning activities for cognitive development the ulcer may have healed almost up to the surface of the epithelium, but it is still a stage 4 ulcer. Clinical standards require that the ulcer continue to be documented as a stage 4 until it has healed. (chapter 3, M1307 (oldest stage 2 pressure ulcer), OASIS-C2 guidance manual, 1/2017)

learning activities for cognitive development

A: on the OASIS, a pressure ulcer treated with a muscle flap is no longer considered a pressure ulcer. It is reported as a surgical wound. If the muscle flap used to treat the pressure ulcer is not healing or the flap begins to fail, the wound should be considered a complicated surgical wound.Learning activities for cognitive development continue to report the wound as a surgical wound on M1340 (surgical wound).

If the muscle flap heals (edges are completely re-epithelialized and the incision is clean, dry and closed with no signs or symptoms of infection for at least 30 days) this becomes a scar and is no longer reported as a surgical wound.Learning activities for cognitive development if a new lesion due to pressure forms on the area that has healed, it is reported as a new pressure ulcer and staged accordingly.

The confusion is in part because of separate, unrelated OASIS-C2 guidance that dictates once a pressure ulcer is completely covered with epithelial tissue, the wound is considered healed, and should no longer be reported as an unhealed pressure ulcer, believes kelly kavanaugh-branam RN, HCS-D, HCS-O, BCHH-C, HCS-H interim quality review nurse, brookdale healthcare services in brentwood, tenn.Learning activities for cognitive development

A reepithelialized pressure ulcer will only ever regain up to 80% of its tensile strength and therefore is never truly healed, according to dea kent, RN, NP-C, CWOCN director nursing home oversight & consulting, in fishers, ind.Learning activities for cognitive development it isn’t clinical practice to reverse stage pressure ulcers because they don’t heal in reverse order and will never be completely restored, she says.Learning activities for cognitive development

In the case of M1306 (does this patient have at least one unhealed pressure ulcer at stage 2 or higher or designated as unstageable), if a shallow depth wound reopens on the area of a closed stage 4 pressure ulcer, it must be staged at its worst historical stage, kent says.Learning activities for cognitive development it should then be staged as a stage 4 and for M1306, response 1 (yes) is correct, according to kent.

Begin your search for a neoplasm code first in the alphabetic index by looking under the tumor’s histology, and then consult the neoplasm table if necessary, or risk assigning an incorrect code for a patient’s cancer diagnosis.Learning activities for cognitive development if you instead jump immediately into the neoplasm table, you could easily end up choosing an incorrect code, says sherri parson, HCS-D, director of staff education for floral park, N.Y.-based coding outsourcer quality in real time.Learning activities for cognitive development learning how to use the alphabetic index and the neoplasm table correctly is a common source of confusion among coders. "We see our novice coders struggle with this so much," parson says.Learning activities for cognitive development

Tip: remember that the procedure of first looking in the alphabetic index before verifying the code in the tabular is instruction that’s taken directly from official coding guidelines [I.B.1].Learning activities for cognitive development for neoplasms that aren’t specified by their histology and that are generally referred to as neoplasms or cancer, the index will lead you to the neoplasm table.Learning activities for cognitive development