PDPM Coding Question – If a resident admits the skilled nursing facility with two pressure ulcers and the ulcers then merge, is it appropriate to continue to code the ulcer as “present on admission”?

If a resident admits the skilled nursing facility with two pressure ulcers and the ulcers then merge, is it appropriate to continue to code the ulcer as “present on admission”?

A:

If two pressure ulcers merge, that were both present on admission, it would be appropriate to continue to code the merged pressure ulcer as “present on admission.”  Although two merged pressure ulcers might increase the overall surface area of the ulcer, there needs to be an increase in numerical stage or a change to unstageable due to slough or eschar in order for it to be considered not “present on admission.”