LOINC Code 46534-4: Skin lesion or open wound during assessment period [CMS Assessment]

What is this code?

LOINC codes identify tests, measurements, observations, survey items, and clinical questions in a standardized way. It is associated with the component Skin lesion or open wound. It is commonly used with the system or sample type ^Patient.

When is it used?

• Used in lab systems, EHRs, and clinical data exchange.
• May identify a test, observation, survey item, or clinical document request rather than a diagnosis.
• Status: ACTIVE
• Order vs observation: Observation
• Method: CMS Assessment

What it does not mean

• The code identifies the observation or test, not the actual result.

Key facts

• Skin lesion or open wound during assessment period [CMS Assessment]
• Skin lesion or open wound
• Identifies the presence of a skin lesion or open wound. A lesion is a broad term used to describe an area of pathologically altered tissue. Sores, skin tears, ulcers, rashes, surgical incisions, crusts, etc. are all considered lesions. Other than lesions that end in "ostomy" (e.g., tracheostomy, gastrostomy, etc.) or peripheral IV sites, all other alterations in skin integrity are considered to be lesions. Persistent redness without a break in the skin is considered a lesion.
• Centers for Medicare and Medicaid Assessment; Finding; Findings; Integument; Ordinal; Ql; Qual; Qualitative; Report period; Screen; Survey

Where you may see this code

You may see this code in lab systems, lab reports, EHR exports, interoperability feeds, or other structured clinical data exchanges.

Common synonyms

Frequently asked questions