I think maybe what the state got you for
is that you have never proven one way or the other if this is an active infection
or a colonization for both the MRSA and VRE. I would attempt to get
follow-up cultures to see if they are cleared, if not, ask the physician to
write notes stating that they are colonized. As for the MRSA in the wound
that has healed, I would not have coded this at all. If the wound has
healed, then there should be no symptomology or reason to believe that the
infection still exists. I would just write a good note stating that the
wound has healed, is not exhibiting any s/s of infection, etc. As for the
hepatitis, I would have coded this as the manual states, “Inflammation of
the liver of viral origin. This category includes diagnoses of hepatitis
A, hepatitis B, hepatitis non-A non-B, hepatitis C, and hepatitis E. Once
someone has hepatitis C, it is usually there to stay.
Brenda W. Chance, RN,
RAC-C
MDS Coordinator
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-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]
Sent: Monday, January 19, 2004
9:54 PM
To: [EMAIL PROTECTED]
Subject: Re: infections
I was
taught at the State Program for Infection Control and Epidemiology at UNC in
NC that if there were no symptoms it wasn't an infection rather it was a
colonization. Therefore I've never coded it as an infection
without it meeting the long term infection criteria requiring symptoms.
I've not had any problems wth the state survey team doing that way
either. I believe most infections are treated 10-14 days maybe longer
in the event of MRSA/VRE. Prehaps the state cited you at 7 days for
that reason, thinking the infection may not have resolved in that short a
time period. Or prehaps it was within the time frame the MDS
identified for coding. I think I would have discussed with them
the resident who was 6 months colonized.
In a message dated 1/19/2004 8:46:13 PM Eastern
Standard Time, [EMAIL PROTECTED] writes:
Hi all
have had a major controversy going on at our facility. Here is the question
say you have a patient come in with MRSA in the nares with lab results but no
s/s of infection. Do you take it in I section, what if some one had
+VRE in urine 6 months ago asymptomatic and never had repeat labs, do you
take it in i section? What if you had some one with Hx of Hepatitis C on a
consult do you code it under viral hepatitis? And again a wound with
MRSA which never had repeat labs and is healed over?
The CRC in our facilty will not claim if not active in past 7 days, state
came in and said it has to be on the MDS during our survey and were cited for
it. Coorporate states not to take it unless it affects the current
picture of patient. What I am looking for and yes we read and reread
the RAI manual, but need to know what to do in these cases. Thanks in
advance suzieq
Susann Irwin, RN
MDS Coordinator
Garner, NC
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