There is a clarification in the manual on
this and I truly believe the manual only means fluids for hydration or
nutrition. On pg. 3-77 under eating, it states “How a resident eats
or drinks, regardless of skill. Includes intake of nourishment by other
means (e.g. tube feeding, total parenteral nutrition). Then on pg. 3-93, “The
item for eating is more complex. If in the past 7 days the resident truly
did not receive any nourishment, the item would be coded 8. If should go
without saying that this is a serious issue. Be careful not to confuse
total dependence with eating (code 4) with the activity itself (in this case,
receiving nourishment and fluids). Keep in mind that a resident who is
fed by tube, and manages the tube feeding independently is coded as
independent. G1h includes receiving fluids for HYDRATION, and is
totally dependent, then is coded as 4, rather than 8.”
Rena, are you out there?
Brenda W. Chance, RN,
RAC-C
MDS Coordinator
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-----Original Message-----
From: Holly Sox, RN, RAC-C
[mailto:[EMAIL PROTECTED]
Sent: Tuesday, January 20, 2004
12:50 PM
To: [EMAIL PROTECTED]
Subject: Re: K5A Coding IV
Piggybacks
Even though it doesn't make a lot of
sense, the instructions in the manual are clear on it. And,
regardless of what you enter in section G, if you include the fluids on section
K (which you should be doing according to the instructions), the ADL index
automatically computes a 3 for eating.
Lots of stuff doesn't make logical
sense, but we do it according to the rules. Whatever the rules are.
This week.
Holly F. Sox, RN, RAC-C
Clinical Editor
----- Original Message -----
Sent: Tuesday,
January 20, 2004 12:35 PM
Subject: Re: K5A
Coding IV Piggybacks
I disagree with the IV hung by staff
changes the coding for eating. If a resident is getting IV ABX and
it is hung by staff it is counted in both K and section P, but since it is not
a hydration issue I do not agree that it should change the coding for
eating. AM I totally off on this one?
In a message dated 1/19/2004 3:52:25
PM Mountain Standard Time, [EMAIL PROTECTED] writes:
It counts for both and also remember
that IV's are part of section G ability to eat. If they get IV's and they
are hung by staff that will change your coding of staff support for eating.
This is something I still have problems with.
----- Original Message -----
Sent: Monday,
January 19, 2004 4:17 PM
Subject: K5A Coding
IV Piggybacks
In the RAI update listed below, CMS seems to be saying that if an IV
medication was given in a 100ml bag hung by it self, it can be counted as both
IV Fluid ( Do include the IV Fluids in
the IV piggybacks.) and in P1ac IV medications. My first
impression is that an IV ABT in the 100ml bag normal saline for example would
be counted only for IV medication. Others are saying that it would count for
both IV Fluids(100ml) and IV meds. -- does it count as one or both --it can
make a real difference if this is a PPS resident?
CHANGES TO THE DECEMBER 2002 RAI MANUAL, VERSION 2.0 AUGUST 2003
Parenteral/IV - Intravenous (IV) fluids or hyperalimentation, including total
parenteral nutrition, given continuously or intermittently. This category also
includes administration of fluids via IV lines with fluids running at KVO (Keep
Vein Open), or via heparin locks. This category does not include administration
of IV medications. Do not code IV
“push” medications here. Do include the IV fluids in IV piggybacks. IV medications dissolved in a diluent, as
well as IV push medications are captured as IV medications in P1ac.
Do not include IV fluids that were administered as a routine part of an
operative procedure or recovery room stay. Do not include insulin administered
intravenously. CH 3 3-154
___________________________
Garnett Wooten RN
Case Mix Manager
Southern Healthcare, LLC
904-612-9893
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