Pressure Ulcer vs Acute Skin Injury/failure
I am wondering if anyone has utilized and/or educated providers regarding documenting Acute skin injury (when definition is met) instead of pressure ulcer and what code is being used for this? Is it an injury code? This may help exclude a few pressure related ulcers that develop rapidly d/t poor tissue perfusion from the HAC and PSI Quality measures. What do providers need to capture in their note for "acute skin injury"?
Thanks,
Alicia
Comments
I am also needing input from other CDI programs on coding of acute skin failure. Our facility has clear definitions of acute skin failure and our providers are documenting it, but our coding team is concerned about the use of the unspecified L98 code. Any input is appreciate?
I should clarify my terms above as Acute skin Failure.
A lot of attention has come to skin failure in the last couple of years. Skin failure is associated with poor perfusion and describes a state of hypoperfusion causing tissue death that occurs simultaneously with a critical illness.
There is a lack of diagnostic criteria to define ASF. It is important to work towards a consensus for an organizationally defined criteria to use for defining skin failure and sending queries. This article may be helpful if considering development of criteria: Advances in Skin & Wound Care (lww.com).
Currently, there is not a code specifically for documentation of acute, chronic, or end-stage skin failure. The guidance is to use L98.9 -Disorder of the skin and subcutaneous tissue, unspecified when not linked to an underlying condition.
There is a Coding Clinic from Q1 2021 that provides guidance to code L99, Other disorders of skin and subcutaneous tissue in diseases classified elsewhere for documentation of skin failure due to underlying coagulopathy and microvascular changes due to COVID-19. If the skin failure is linked to an underlying etiology, code L99 would be appropriate.
Hope this helps.
Thank you Kelly!