Q&A: A resident was recently admitted with multiple fractures related to an ATV accident. Is it appropriate to use Z47.89, Encounter for other orthopedic aftercare, as the principal diagnosis code?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A resident was recently admitted with multiple fractures related to an ATV accident. Is it appropriate to use Z47.89, Encounter for other orthopedic aftercare, as the principal diagnosis code?    Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: You cannot use aftercare Z codes when related to injuries …

Q&A: I am confused with what can be included at O0110A1, chemotherapy while a resident. A resident is currently receiving Ibrance, as part of her cancer treatment. Can I code oral chemotherapy? 

MDS 3.0 and the RAI Process / NAC / Q&A

Question: I am confused with what can be included at O0110A1, chemotherapy while a resident. A resident is currently receiving Ibrance, as part of her cancer treatment. Can I code oral chemotherapy?  Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Ibrance is a kinase inhibitor used to treat breast …

Q&A: A resident recently admitted to us with over 20 pressure ulcers and 10 of these are deep tissue pressure injuries. M0300 only allows us to enter a single digit amount 0-9 on the MDS. How do we code when it is 10 or more?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A resident recently admitted to us with over 20 pressure ulcers and 10 of these are deep tissue pressure injuries. M0300 only allows us to enter a single digit amount 0-9 on the MDS. How do we code when it is 10 or more? Answer from Carol Maher, RN, …

Q&A: I completed the pain interview with the resident two days before the ARD and he reported no pain. How do I code this when it conflicts with other medical record documentation?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: I completed the pain interview with the resident two days before the ARD and he reported no pain. How do I code this when it conflicts with other medical record documentation? Answer from Jeff Taylor: Follow the manual for both items. One reflects what the resident told you in the …

Q&A: Would it be considered a delusion if a resident who has dementia states that they have a girlfriend in the absence of one, needs to go find their parents/spouse who are deceased, or needs to go find their truck so that they may go home?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: Would it be considered a delusion if a resident who has dementia states that they have a girlfriend in the absence of one, needs to go find their parents/spouse who are deceased, or needs to go find their truck so that they may go home? Answer from Jeff Taylor: …

Q&A: Is total parenteral nutrition (TPN) coded in MDS items O0110H (IV Medication), K0520A (Parenteral/IV Feeding), and K0710 (Percent Intake by Artificial Route)?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: Is total parenteral nutrition (TPN) coded in MDS items O0110H (IV Medication), K0520A (Parenteral/IV Feeding), and K0710 (Percent Intake by Artificial Route)? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: TPN is an IV fluid for nutrition or hydration, so it would be coded in section K. It …

Q&A: When is the new Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) (2024) required to be used?  

Billing and Reimbursement / NAC / Q&A

Question: When is the new Skilled Nursing Facility Advanced Beneficiary Notice (SNF ABN) (2024) required to be used?   Answer from Jessie McGill, RN, BSN, RAC-MT, RAC-MTA: The updated SNF ABN (2024), CMS form 10055, must be used starting Oct. 31, 2024. The updated form is located on the FFS SNF …

Q&A: A resident had a right below-knee amputation (BKA) a month ago and a Significant Change in Status Assessment (SCSA) was completed at that time. The resident is now going back to have a revision done from the BKA to above-knee amputation (AKA). Would the second surgery be considered a significant change also?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A resident had a right below-knee amputation (BKA) a month ago and a Significant Change in Status Assessment (SCSA) was completed at that time. The resident is now going back to have a revision done from the BKA to above-knee amputation (AKA). Would the second surgery be considered a …

Q&A: I transmitted an assessment with an ARD of 10/3/24. Our software scrubber said the assessment had an error because I signed Z0500 on 10/3/24. The assessment was accepted by CMS. Is there a penalty for early completion of the MDS?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: I transmitted an assessment with an ARD of 10/3/24. Our software scrubber said the assessment had an error because I signed Z0500 on 10/3/24. The assessment was accepted by CMS. Is there a penalty for early completion of the MDS? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: …

Q&A: Please clarify the law regarding ICD-10 coding of HIV (B20). Is it a HIPAA violation to include this diagnosis under the medical diagnoses section in the medical record?    

MDS 3.0 and the RAI Process / NAC / Q&A

Question: Please clarify the law regarding ICD-10 coding of HIV (B20). Is it a HIPAA violation to include this diagnosis under the medical diagnoses section in the medical record?  Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: It would be appropriate and HIPAA compliant to have the HIV diagnosis …