MDS Alert

Published on Tue Apr 16, 2013 PDF

Test your skill with these scenarios.

Try your hand at these three scenarios for coding those “gray-area” situations under O0100: Special Treatments, Procedures, and Programs.

Scenario #1: One week prior to entering the facility, Mr. Smith received chemo for cancer and IV medications. After entering the facility, he continued receiving radiation treatments for cancer 10 days after admission and stopped IV medications after three days in the facility.

How to code: For this scenario, you would check Column 1 for O0100A Chemotherapy, and then check Column 1 for O0100H IV Medications. Then you would check Column 2 for O0100B Radiation and Column 2 for the IV medications that he received after admission (O0100H).

Caveat: If Mr. Smith received the IV medications in conjunction with the chemo or radiation treatments, you would not code them. So you actually need to know a little more about the IV medications to know whether you can actually capture it, Rena Shephard, president of RRS Healthcare Consulting Services in San Diego, CA and a member of the MDS 3.0 development team, said in a Centers for Medicare & Medicaid Services (CMS) presentation.

Scenario #2: Mr. Jones is taking Megastrol, an antineoplastic drug with the side effect of being an appetite stimulant. He is taking the drug to stimulate his appetite, but he does not have cancer.

How to code: Although Megastrol is indeed an antineoplastic drug, you do not code this under O0100A, because “the rule is that you’re going to code it only if the resident is receiving it for cancer,” Shephard explained.

Scenario #3: While a resident of your facility, Mrs. Brown received IV medications and oxygen therapy. She was discharged on day three of the look-back period, after which she received radiation and oxygen therapy. She was re-admitted on day 13 and received oxygen therapy and radiation.

How to code: Check Column 2 for O0100H IV Medications and O0100C Oxygen Therapy, which Mrs. Brown received while a resident, before her discharge. Then, you would check Column 2 for O0100B Radiation and O0100C Oxygen Therapy for the treatments she received after her discharge. You would code the oxygen therapy and radiation that Mrs. Brown received after re-entry by checking those items in Column 2.