Q&A: Is a “Level 7-Easy to Chew” diet coded as a mechanically altered diet?

Question: Is a “Level 7-Easy to Chew” diet coded as a mechanically altered diet?  Could there be ADR concerns? Note: “Level 7-Easy to Chew” is from the International Dysphagia Diet Standardization Initiative (IDDSI), more information is available here:  iddsi.org/IDDSI/media/images/ConsumerHandoutsAdult/… Answer from Jeff Taylor This does not appear to be a …

Q&A: To code isolation in section O, does the isolation need to be every day during the look-back period?

Question: To code isolation in section O, does the isolation need to be every day during the look-back period?  Also, if the resident has COPD and shortness of breath is not documented, but it is documented once that the head of the bed is elevated related to shortness of breath …

Q&A: Is a Notice of Medicare Noncoverage (NOMNC) beneficiary notice required when the resident and family request services be ended?

Question: A resident is receiving speech-language pathology services under Medicare Part B. The resident and family decided they no longer want to pay the copays and requested services be ended. Is a Notice of Medicare Noncoverage (NOMNC) beneficiary notice required in this situation?  Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, …

Q&A: If two PHQ mood interviews were completed during the look-back period, which should we use?

Question: If two PHQ mood interviews were completed during the look-back period, which should we use? Our social services worker completes the PHQ mood interview, but sometimes one is also completed by the psychologist/ psychiatrist during the look-back. Which interview should I use to code the MDS? Answer from Jeff …

Q&A: If a resident triggered the Quality Measure for long-stay indwelling catheter in Jan. 2024 and then passed away, would his passing remove him from triggering the measure?

Question: If a resident triggered the Quality Measure for long-stay indwelling catheter in Jan. 2024 and then passed away, would his passing remove him from triggering the measure? Answer from Jessie McGill, RN, BSN, RAC-MT, RAC-MTA  When a resident passes away or discharges, this does not remove them from the …

Q&A: If a resident is care planned for a certain expected behavior, must we code the behaviors on the MDS?

Question: If a resident is care planned for a certain expected behavior, must we code the behaviors on the MDS? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC You must code any behaviors that occurred during the 7-day look-back from the ARD. This AAPACN resource is copyright protected. …

Q&A: Can a long-term care resident who exhausted his Medicare benefits three months ago, but continued to receive dialysis three times per week earn a new 100-day benefit period?

Question: A long-term care resident who is on dialysis three times per week exhausted his Medicare benefits and has been in the facility with Medicaid as the primary payer for the last three months. He recently had a new qualifying hospital stay but does he have a new 100-day benefit …

Q&A: Is the facility responsible for the expense of a family requested specialty enteral tube feeding formula for a resident on a Medicare Part A stay?

Question: Is the facility responsible for the expense of a family requested specialty enteral tube feeding formula for a resident on a Medicare Part A stay? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC The facility is responsible for the cost of the tube feeding formula. If the …

Q&A: If a resident goes to the emergency room and gets IV fluids, and the IV is removed prior to returning to a non-overnight visit during the ARD period, is O0110O1, IV Access, checked on the MDS? 

Question: If a resident goes to the ER and gets IV fluids, and the IV is removed prior to returning to a non-overnight visit during the ARD period, is O0110O1, IV Access, checked on the MDS?  Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO:If there was no …