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Mary Lynn,
There was some confusion with the December 2002
Manual regarding this issue. However, the August updates clarified the CMS
position, which is that pain is to be coded if present.
If someone is on a routine pain management program,
and never requires prn med for breakthrough pain, and never reports any
breakthrough pain, then code 0. If they request and receive pain med (or
any other intervention for c/o pain) and pain is relieved, you still need to
code for the pain, as daily or less than daily, as well as the intensity of the
pain at its worst.
Holly
Holly F. Sox, RN, RAC-C
Clinical
Editor
----- Original Message -----
Sent: Friday, March 19, 2004 12:39
PM
I am still confused about coding for pain
management. In one reply this past week one person stated that if pain
med is effective and relieving pain then they code 0. I always thought
if they had pain you code it. I talked with another MDS coordinator in
my area and she states that if the pain regime is controlling the pain you
code 0 even though they have pain at times. In the RAI mannual it states
The Resident's goal for pain management is being met. So if thier pain
level is under thier ALOP could you code a 0. Lots of times these
Residents do not fully understand thier acceptable level of pain or the
pain scale. I am confused again as to how to understand if thier goal
for pain management is being met. She also mentioned that someone
from Qualis Care explained it to her this way. So the way we learn to
code our pain is effecting our scores on Nursing Home Compare even if we are
coding wrong. So these compares may not be accurate. I would
appreciate if someone could help clarify this problem again as I am confused
. Thanks Mary Lynn
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