03/29/04
Thank you so much for responding to my question. 
Can you locate the source document for me that indicates we are to code
based on this information? The clarification in the RAI Manual states, "Code
according to a drug's pharmacological classification, not how it is used."
For example, Serax may be used as a hypnotic but it is classfied as an
antianxiety. Serax would be coded as an antianxiety...."  CMS does not
provide us with the "pharmacological" resource we should refer to other than
the very limited Appendix E and even it Appendix E it states for diuretics
to "consult pharmacist, the resident's physician, or a drug reference
manual."  By consulting the pharmacsit, physician etc. are we not trying to
determine how it is used which is in direct conflict to the clarification. 
I have high hopes CMS will clarify this one for us. I appreciate your
thoughts.
 

-----Original Message-----
From: Holly Sox, RN, RAC-C [mailto:[EMAIL PROTECTED]
Sent: Monday, March 29, 2004 2:53 PM
To: [EMAIL PROTECTED]
Subject: Re: Section 04


Landa,
I am not Rena, but  would like to  respond to the part of your question
regarding Prinizide.  Prinizide, Zestoretic, etc are combination products
which include an antihypertensive (such as ACE inhibitor or Ca channel
blocker) and a diuretic (usually HCTZ)  So these combination products need
to be coded as diuretics.
 
As far as Phenobarbital,  the term "anticonvulsant" is a very broad category
which encompasses several different drug actions.  Phenobarb is listed under
the anticonvulsants (as are valium and Klonopin) but their actions are
described according to drug class (ie barbiturate or benzodiazepine) 
 
Hope this is helpful.
 
Holly
Holly F. Sox, RN, RAC-C
Clinical Editor
 
www.careplans.com <http://www.careplans.com>    [EMAIL PROTECTED]
<mailto:[EMAIL PROTECTED]>  


----- Original Message ----- 
From: Landa Stricklin <mailto:[EMAIL PROTECTED]>  
To: '[EMAIL PROTECTED]' <mailto:'[EMAIL PROTECTED]'>  
Sent: Monday, March 29, 2004 2:12 PM
Subject: Section 04


03/29/04
Good Afternoon,
Rena I am sure you have addressed this before but I would like clarification
from your office if possible.
In section 04 under Intent, Appendix E is referenced. But, then the
clarification states to code drugs according to there classification not how
it is used, which came out after Appendix E.
The confusion: Phenobarbitol is listed under Appendix E as an antianxiety
but other resources such as the Nursing Drug Handbook list it as an
anticonvulsant. How should I code this? The same confusion arises with
Prinizide which is classifed as an Antihypertensive but has diuretic
affects? 

Thank you

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