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My Bad....
I was thinking of IV fluids and the discussion we
had a couple of weeks ago about that.
Gotta stop hitting reply on these things before
lunch.
HS
Holly F. Sox, RN, RAC-C
Clinical Editor
----- Original Message -----
Sent: Tuesday, January 20, 2004 1:56
PM
Subject: RE: K5A Coding IV
Piggybacks
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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