'Tis the season when residents get the flu or receive flu immunizations, so test your MDS coding prowess on these three scenarios.
Scenario 1. Mrs. F had been doing well and was ready for discharge to the apartment in elderly housing until she came down with the flu. Currently she has a low-grade fever, general aches and pains, and respiratory symptoms of productive cough and nasal congestion. Although she has taken to bed for a few days, she has had no change in ADL function, mood, etc., and is looking forward to discharge in a few days.
How would you code Section J5 (stability of conditions) for this resident, according to the RAI manual?
Scenario 2. The resident receives a flu shot and a vitamin B12 injection on Thursday during the assessment reference period window for O3 (the number of days of injections in the last seven days).
Scenario 3. You administer a flu shot to Ms. Jones within the seven-day lookback for Section O1. But would you count the immunization in O1 (number of medications) or just in O3?
Answers:
Scenario 1. Check 'b' for an acute condition.
Scenario 2. Code "1" because the resident received two injections in the same day within the seven-day period.
Scenario 3. Yes, says Rena Shephard, RN, MHA, president of RRS Healthcare Consulting Services in San Diego. Count the flu shot in O1 and also in coding O3 (injections).