March 5, 2021

If the laceration /skin tear requires no treatment such as suturing is it PTOS? If no repair needed would it be considered superficial? ( which is excluded)

It all comes down to the ICD-10-CM diagnosis code. Lacerations do typically fall within our ICD-10-CM inclusion code range. It is the superficial abrasions and contusions that are excluded.

If the patient has an ICD-10-CM diagnosis code that falls within the PTOS inclusion code range AND the patient meets another portion of the criteria (i.e. LOS, transfer, etc.), the patient should be captured as PTOS.

Treatment vs no treatment or medical admissions no longer play a role in determining inclusion.

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