Wound Care Made Incredibly Easy

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Moisture-associated skin damage

modification called the ICD-10-CM. The definition from the ICD 10-CM for MASD is “irritant contact dermatitis due to friction, sweat ing, or contact with body fluids.” This is an improvement from “diaper dermatitis” in the ICD-9, reflecting more current science thanks to the work of the Wound, Ostomy, and Continence Nurses Society™ and others who testified to Congress to get more precise terms. ICD-10-CM codes for MASD conditions • L24.A0 Irritant contact dermatitis due to friction or contact with body fluids, unspecified – L24.A1 Irritant contact dermatitis due to saliva – L24.A2 Irritant contact dermatitis due to fecal, urinary, or dual incontinence – L24.A9 Irritant contact dermatitis due to friction or contact with other specified body fluids • L24.B0 Irritant contact dermatitis related to unspecified stoma or fistula – L24.B1 Irritant contact dermatitis related to digestive stoma or fistula – L24.B2 Irritant contact dermatitis related to respiratory stoma or fistula – L24.B3 Irritant contact dermatitis related to fecal or urinary stoma or fistula If you work in an organization that bills insurance for care and supplies, you have someone (or a team) that determines ICD-10-CM codes for billing purposes. They may get this from a medical diagnosis but quite often, especially for more superficial skin issues, they look at the nurses’ documentation. It is more important than ever to be specific when it is moisture that causes damage. When you chart the pattern (diffuse edges rather than distinct edges like a pressure injury) and the location (in the area affected by incontinence or around a wound, stoma, or in a moist skin fold), more appropriate reimburse ment occurs because the condition was coded correctly. Excessive moisture buildup in skin folds can cause intertriginous der matitis (ITD), also called erythema intertrigo. This type of MASD often appears as a symmetrical shape on the opposing skin surfaces (mirror image). In a deep skin fold, there is little or no opportunity for mois ture to evaporate, and the two opposing skin surfaces slide against each other, creating friction in a high-risk environment of overhydrated skin. The first sign of injury is inflammation. The skin then becomes edematous and likely peels. This sets up an ideal environment for pathogens such as bacteria and fungi to proliferate, especially since overly moist skin develops an alkaline pH over time, which favors the pathogens. Areas most likely to be affected include the inframammary

Intertriginous dermatitis

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