MDS Alert
Would You Code Abnormal Labs At P9 For These Residents?
PDF
Question No. 1: Mrs. Smith receives warfarin (Coumadin) for a recent bout of thrombophlebitis. Mrs. Smith's prothrombin times are abnormally elevated but in the therapeutic range for her. Would you code "1" for "yes" at P9 that Mrs. Smith has abnormal lab values?
1. No, because anticoagulation testing is excluded from P9.
2. No, because even though her prothrombin times are elevated, they are therapeutic for her.
3. Yes, the prothrombin times are abnormal even though that's the desired effect.
Question No. 2: Mr. Jones has diabetes mellitus and receives finger-sticks for blood glucose testing. His glucose was recorded as being abnormally high one time 50 days ago (from the assessment reference date for the MDS). Would you code him as having abnormal lab values?
1. No, you don't include finger-stick blood tests in coding P9.
2. Yes, his glucose has been abnormal and you do include results obtained via finger-sticks.
3. No, because Mr. Jones' abnormal glucose results occurred outside the 30-day lookback period for P9.
Question No. 3: Mr. Adams was admitted to the SNF two weeks ago. His lab values have been normal since, but he had electrolyte imbalances in the hospital a week before admission to the SNF. Would you code him as having abnormal lab values at P9?
1. Yes, you count hospital lab results in the lookback.
2. No, P9 refers only to laboratory tests performed after admission to the nursing facility.
Coding Quiz Answers:
Question No. 1: The answer is option 3. An elevated prothrombin time in a resident receiving Coumadin therapy is coded "1" for "yes," even though this may be the desired effect, according to the RAI user's manual. "Abnormal" refers to laboratory values that are abnormal when compared to standard values, not abnormal for a particular resident.
Question No. 2: The answer is option 2. Abnormal blood glucose levels, including levels obtained via finger-sticks are included in this item, states the RAI user's manual. The lookback for coding P9 is 90 days or since admission. You code "1" for yes (abnormal) if the resident has had at least one abnormal lab value.
Question No. 3: The answer is option 2. Item P9 refers only to laboratory tests performed after admission to the nursing facility, according to the RAI user's manual.
MDS Alert
- MDS Accuracy:
Is 'Garbage In, Out' Syndrome Trashing Your MDSs?
5 ways to keep your assessments and coding from going astray.
Over time, inaccurate MDS assessments [...] - ADL Coding Tipster:
Dig Deeper When You See Limited Assistance
That holds especially true for a rehab patient.
You don't want inaccurately reported limited assistance for [...] - Pressure Ulcers:
New Staging Guidelines Increase Pressure To Juggle Standard Of Care And MDS Coding
Navigate the growing gap between the NPUAP guidelines and MDS.
The updated National Pressure Ulcer Advisory [...] - Medicare:
If A Resident Has Dehydration, Look To See If You've Captured These Conditions, Services
This way your coffers won't run dry due to untapped payment.
If a resident has dehydration, [...] - Risk Management Tip:
Chart The Good News About A Resident With A Wound
Spell out how the resident is doing well.
Suppose a nurse doesn't document that a patient [...] - Best Practices:
Prevent Unnecessary Rehospitalizations With Triage And Lab Strategies
Don't be known as the SNF that bounces residents back to the hospital.
Concern about rehospitalization [...] - What Do You Think? Which ICD-9-CM Code Should You Use For Dehydration?
The ICD-9 manual used to have only one catch-all code for volume depletion, which was [...] - Best Practices:
Certain MDS Items Flag Residents With Higher Acuity
Let your documentation spell out your assessment, care.
If your preadmission or admission assessment reveals a [...] - Coding Quizzer:
Would You Code Abnormal Labs At P9 For These Residents?
Question No. 1: Mrs. Smith receives warfarin (Coumadin) for a recent bout of thrombophlebitis. Mrs. [...] - Trends:
Could The CARE Postacute Assessment Tool Replace The MDS?
Find out why you should care about the CARE.
Potentially coming to SNFs, home health, inpatient [...] - Continuing Education:
Hear The Latest And Greatest About Urinary Incontinence, Pressure Ulcer Care
Get a 15 percent discount on your next audioconference.
Incontinence affects more [...] - Clip and Save:
Evaluate Infection Assessment
Find out if your approach needs debugging.
Does your facility complete a comprehensive assessment for residents [...] - MDS & Billing News
--Ready for a Medicare Part A reimbursement boost? The Centers for Medicare & Medicaid Services [...]