Yesterday I discussed the challenges of ICD-10 coding late effects of radiation. Last week I showed you the axillae of a lady after breast cancer who had radiation changes and a non-healing wound. Her transcutaneous oximetry values on leads 1 and 3 were 8mmHg and 2mmHg respectively. A normal value in the upper extremity should be over 50 mmHg. No wonder she is not healing. Yes, you can use TCOM in places other than the lower extremity if you think there is tissue hypoxia. In this case the tissue hypoxia is due to the late effects of radiation. Next week you can see what happens with an oxygen challenge.