The RAI User's Manual instructions are to code Section J2 for the level of pain the resident experienced, regardless of pain management efforts.  See the "coding" instructions at the bottom of page 3-141. 

If the resident experienced no pain during the observation period while on a pain management program, the correct code is "0," No pain.  If the resident had no pain regardless of the reason, but experienced breakthrough pain even once, the coding for J2 must reflect the level of pain the resident experienced.

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
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Subj: Coding Pain
Date: 1/7/04 5:26:20 PM Pacific Standard Time
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Coding Pain,

I need help with coding pain symptoms (Sec J2). I have always thought that you code pain (any type) if the resident had pain in the last 7 days no matter what interventions were implemented. The question has come up regarding how to code for residents receiving routine pain meds and breakthrough pain. Please share how you code this section.

Deanna Kennedy RN
MDS Coordinator
Veterans Home of CA
Yountville
(707) 944-4981







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