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Coding Quizzer:

How Would You Code These 2 RAI Manual Examples at H0300 (Urinary Incontinence)?

Published on Thu Feb 23, 2012

Scenario No. 1: "An 86-year-old female resident has had longstanding stress-type incontinence for many years," states the April 2012 RAI manual. "When she has an upper respiratory infection and is coughing, she involuntarily loses urine. However, during the current 7-day look-back period, the resident has been free of respiratory symptoms and has not had an episode of incontinence," states the manual.

Scenario No. 2: "A resident with Parkinson's disease is severely immobile, and cannot be transferred to a toilet," states the RAI manual. "He is unable to use a urinal and is managed by adult briefs and bed pads that are regularly changed. He did not have a continent void during the 7-day look-back period."

Here are the coding options verbatim from the RAI manual:

"Code 0, always continent: if throughout the 7-day look-back period the resident has been continent of urine, without any episodes of incontinence.

Code 1, occasionally incontinent: if during the 7-day look-back period the resident was incontinent less than 7 episodes. This includes incontinence of any amount of urine sufficient to dampen undergarments, briefs, or pads during daytime or nighttime.

Code 2, frequently incontinent: if during the 7-day look-back period, the resident was incontinent of urine during seven or more episodes but had at least one continent void. This includes incontinence of any amount of urine, daytime and nighttime.

Code 3, always incontinent: if during the 7-day look-back period, the resident had no continent voids.

Code 9, not rated: if during the 7-day look-back period the resident had an indwelling bladder catheter, condom catheter, ostomy, or no urine output (e.g., is on chronic dialysis with no urine output) for the entire 7 days," states the RAI manual.

Coding Quizzer Answers

Scenario No. 1: "Coding: H0300 would be coded 0, always continent. Rationale: Even though the resident has known intermittent stress incontinence, she was continent during the current 7-day look-back period," states the RAI manual.

Scenario No. 2: "Coding: H0300 would be coded as 3, always incontinent. Rationale: The resident has no urinary continent episodes and cannot be toileted due to severe disability or discomfort. Incontinence is managed by a check and change in protocol," states the RAI manual.

Source: April 2012 RAI manual.

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