Re: Section K

[Debbie Nichols]

I totally agree.  The reason they are on a mech altered diet is because they have chewing or swallowing problems.  This problem would then need to be coded until the resident is able to eat a regular diet if that is ever possible again.  I remember one time someone in our facility thought that it should not be coded since the Resident was able to chew his "soft diet" food without difficulty.  We argued that if the Resident didn't have a chewing or swallowing problem they wouldn't need the "soft diet".  I think we finally convinced her. It's nice to know we were not the only ones with this problem.  Debbie Nichols, RN, RAC-C ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Sunday, February 22, 2004 12:00 PM Subject: Re: Section K Now you are into my disagreement with a previous CMS interpretation of coding chewing and swallowing.  For years we coded this [if] it applied to a mechanically altered diet.  Then CMS published a Q&A stating that if the intervention was successful we shouldn't code the c&S difficulty.  So..........for a year we did not; and for that year I argued with CMS.  Think about it, if all of the care plan interventions 'were successful' then on subsequent MDS assessments there would be no evidence that the resident required skilled care.  If the resident continues to require the intervention, in this case the mechanically altered diet, then the condition is still present.  If not give her filet mignon and improve the quality of her life. Then the new manual was published, See page 3-149 K1a ...Code swallowing problem even when interventions have been successfully introduced.  Same is stated for chewing Delores Dawn you are correct. If the diet is changed/ Mech etc, then it is d/t a chewing or swallowing problem. On our state site for transmittals, this statement continues to be posted, around 2 years ago I believe in July. Not at work, so can't give exact date. I personally feel that if the diet is altered so that the resident doesn't experience difficulty w/eating their foods and the intervention worked---there is not a problem. Delores L. Galias, RN, RHIT STATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments.  Thank you for your cooperation