Based on the understanding that mucosal PrUs cannot be staged because anatomical tissue comparisons cannot be made, CMS directs that in LTCH, mucosal ulcers should not be coded on the LTCH CARE Data Set (http://http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/LTCH-Quality-Reporting/). In long-term care (LTC), these ulcers are not coded in section M for PrUs, but rather in a different section for abnormal mouth tissue for oral mucosal ulcers (http://http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html).
For inpatient rehabilitation facilities (IRF), CMS has issued the draft of the IRF-Patient Assessment Instruments Version 1.2 (http://http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS/IRFPAI.html), which will become effective October 1, 2014. Current questions 48, 49, and 50 (one quarter of a page) are completely revised and replaced with 3.5 pages. More important, this represents the first time that 3 care settings (LTC, LTCH, and IRF) will have consistent numbers and items for PrU reporting. Other care settings may want to take notice of what PrU documentation CMS is requiring.