M1324 — Stage of Most Problematic Unhealed Pressure Ulcer/Injury that is Stageable
Response options, how to score it, and the error that most often sends the record back. Cited to Ch. 3, Item M1324.
Response options
| Value | Meaning |
|---|---|
| 1 | Stage 1 |
| 2 | Stage 2 |
| 3 | Stage 3 |
| 4 | Stage 4 |
| NA | Patient has no pressure ulcers/injuries or no stageable pressure ulcers/injuries |
How to score it
First determine which pressure ulcers/injuries are stageable versus unstageable (unstageable = covered by a non-removable dressing/device, wound bed obscured by necrotic tissue with no Stage 4 structures visible, or presenting as a deep tissue injury). Then code the stage of whichever stageable ulcer is 'most problematic' — the largest, the most advanced stage, or the hardest to access or treat; if there's only one stageable ulcer, it's automatically the most problematic. Code NA if the patient has no pressure ulcers, or only unstageable ones. Dash is not a valid response for this item.
The common error
Reverse-staging a healing ulcer to a lower number — CMS requires a pressure ulcer previously classified at a higher stage to keep being reported at that higher stage until fully healed, even once it looks less severe on exam (a Stage 4 ulcer that is now granulating is still reported as Stage 4).
Source: OASIS-E2 Guidance Manual — Ch. 3, Item M1324. Verified 2026-04-26.
Nearby Section M items
- M1306Unhealed Pressure Ulcer/Injury at Stage 2 or Higher
- M1311Current Number of Unhealed Pressure Ulcers/Injuries at Each Stage
- M1322Current Number of Stage 1 Pressure Injuries
- M1330Does This Patient Have a Stasis Ulcer?
- M1340Does This Patient Have a Surgical Wound?
- M1342Status of Most Problematic Surgical Wound that is Observable
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