Answers:
- As far as coding as biliary
drain in section H, it states that an ostomy is “any type of
excretory ostomy of the GI or GU tract.” It further states at
the bottom of pg. 3-125 that “only ostomies used for elimination”
are coded in section H. So, I don’t think I would code it in
section H. You certainly wouldn’t code in section K. Since
you wouldn’t code in either H or K, then I would not code in section
P. Is this related to a recent surgery? Maybe that would be
way to code it and include the dressing changes in section M.
- The OMRA is not due
by day 8, 9, or 10, but the ARD for the OMRA needs to be set for the 8th,
9th, or 10th day after therapy d/c if the resident
continues to qualify for skilled care. If the resident was
discharged from part a on day 11 after therapy d/c, then I would not do
the OMRA as your last covered med a day would be day 10.
- Bacteremia is
defined per taber’s as bacteria in the blood. You would only
code this in section I as septicemia if the resident met the criteria
described in the MDS manual which says, “Morbid condition associated
with bacterial growth in the blood. Septicemia can be indicated once
a blood culture has been ordered and drawn. A physician’s
working diagnosis of septicemia can be accepted, provided the physician
has documented the septicemia diagnosis in the resident’s clinical
record.” Septicemia is usually a bacterial infection that has
become rampant and has caused multi-system failure. Some residents
are fortunate enough to have bacteria that never goes into septicemia.
For bacteremia, I would just use the ICD-9 code that is correct and code
it in section I3 if needed.
Brenda W. Chance, RN, RAC-C
MDS Coordinator
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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Monday, February 02, 2004
11:46 AM
To: [EMAIL PROTECTED]
Subject: biliary
tube/omra/bacteremia (Rena help please)
Hi everyone, I have several
questions:
1) Is biliary tube considered an ostomy?
2) Omra is due on the 8,9,10 but pt. is discharged on the 11th day.
Do we need to do an OMRA?
3) Where do we code bacteremia? Sorry, I have posted this question 3
times and didn't get an answer.
Thank you.
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