DiraChart MDS item reference
M0300F1Section Mv1.20.1Manual page M-23
Unstaged slough/eschar: number present
This item is referenced against CMS MDS source materials. Verify coding against the current CMS RAI Manual, item set instructions, and facility documentation before submission.
Quick codingAnswer Codes
Use the item-specific response choices below when structured codes apply.
Response format: Numeric entry
M0300F1 — Unstaged slough/eschar: number present
Enter the value requested for this item using the current CMS numeric entry format. Verify the entry against Manual page M-23 and the supporting facility documentation.
Item-specific instructionsCoding Guidance
Review what the item asks, how to choose the response, and what should be verified before submission.
RAI Manual v1.20.1Steps for Assessment
1. Determine the number of pressure ulcers that are
unstageable due to slough and/or eschar.
2. Identify the number of these pressure ulcers that were present on admission/entry or reentry
(see page M-7 for assessment process).
DEFINITIONS
SLOUGH TISSUE
Non-viable yellow, tan, gray,
green or brown tissue;
usually moist, can be soft,
stringy and mucinous in
texture. Slough may be
adherent to the base of the
wound or present in clumps
throughout the wound bed.
ESCHAR TISSUE
Dead or devitalized tissue
that is hard or soft in texture;
usually black, brown, or tan in
color, and may appear scab-
like. Necrotic tissue and
eschar are usually firmly
adherent to the base of the
wound and often the sides/
edges of the wound.
M0300F: Unstageable Pressure Ulcers Related to Slough and/or
Eschar (cont.)
Manual page M-23RAI Manual v1.20.1Coding Instructions
for M0300F
M0300F1
•
Enter the number of pressure ulcers that are unstageable related to slough and/or
eschar.
•
Enter 0 if no unstageable pressure ulcers related to slough and/or eschar are present and
skip to M0300G, Unstageable – Deep tissue injury.
M0300F2
•
Enter the number of these unstageable pressure ulcers related to slough and/or eschar
that were first noted at the time of admission/entry AND—for residents who are reentering
the facility after a hospital stay that were acquired during the hospitalization (i.e., the
unstageable pressure ulcer related to slough and/or eschar was not acquired in the nursing
facility prior to admission to the hospital).
•
Enter 0 if no unstageable pressure ulcers related to slough and/or eschar were first noted
at the time of admission/entry or reentry.
Manual page M-23RAI Manual v1.20.1Coding Tips
•
Pressure ulcers that are covered with slough and/or
eschar, and the wound bed cannot be visualized, should
be coded as unstageable because the true anatomic
depth of soft tissue damage (and therefore stage) cannot
be determined. Only until enough slough and/or eschar
is removed to expose the anatomic depth of soft tissue damage involved, can the stage of
the wound be determined.
•
Stable eschar (i.e., dry, adherent, intact without erythema or fluctuance) on the heels
serves as “the body’s natural (biological) cover” and should only be removed after careful
clinical consideration, including ruling out ischemia, and consultation with the resident’s
physician, or nurse practitioner, physician assistant, or clinical nurse specialist if
allowable under state licensure laws.
•
Once the pressure ulcer is debrided of slough and/or eschar such that the anatomic depth
of soft tissue damage involved can be determined, then code the ulcer for the reclassified
stage. The pressure ulcer does not have to be completely debrided or free of all slough
and/or eschar tissue in order for reclassification of stage to occur.
DEFINITION
FLUCTUANCE
Used to describe the texture
of wound tissue indicative of
underlying unexposed fluid.
M0300F: Unstageable Pressure Ulcers Related to Slough and/or
Eschar (cont.)
Manual page M-23 MDS item matrixAssessment Applicability
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