MDS Alert

You know to code the flu vaccine in Section O, but are you forgetting something?

Brush up on MDS item O0250 (Influenza Vaccine) coding accuracy and snafus. And don’t forget that other item when recording the administration of an influenza vaccination.

When planning annual vaccination schedules, remember these particulars, per the RAI Manual:

• If a resident or staff member is moderately or severely ill when your facility is administering influenza vaccinations, wait to vaccinate that resident until he or she recovers. Residents or staff who are suffering from mild illness should be OK to get the vaccination.
• The influenza vaccine may be given at the same time as other vaccines, including pneumococcal vaccine.
• Influenza infection can occur at any time, and residents should be vaccinated as soon as the vaccine is available in your facility’s area.
• Once the flu vaccine is administered to the resident for the current season (2017-2018, for this year), that same value is carried forward until the next flu season (2018-2019).

MDS Assessment Basics

• Look over the resident’s clinical record and search for any evidence that he received a flu vaccine already.
• Double-check with the resident about his flu vaccine status, especially if you cannot find any evidence in the clinical record. Ask him whether he received a vaccination, and whether it was administered in the facility or elsewhere.
• If the resident cannot answer, check with family or designated representative or the primary care physician.
• If you still can’t find out whether the vaccine has already been administered for the current flu season, “administer the influenza vaccine to the resident according to standards of clinical practice,” according to the RAI Manual.

Coding Instructions
Use your answers to these questions to code MDS item O0250 (Influenza Vaccine), including all sub-items.

When coding O0250A (Did the resident receive the influenza vaccine in this facility …), use 0 (No) or 1 (Yes) per the results of your assessment and concurrent resident interview.

If you code 1 (Yes) for O0250A, code the date the vaccine was administered in this year’s influenza vaccination season, for O0250B, using the appropriate numerals for the month, date, and year. If the corresponding numeral for the month or day is a singledigit, use a 0 first (i.e., Sept. 9, 2017, would be 09-09-2017). If you have no evidence of the exact date, put a single dash in the first box.

If you code 0 (No) for O0250A, you need to code the reason the vaccine was not administered during this year’s flu vaccine season. Your options to code sub-item O0250C are:

1 (Resident not in facility …) Use this option if the resident was not in your facility during this year’s flu vaccination season.
2 (Received outside of this facility) Use this option if the resident received the vaccine elsewhere, like at the primary care physician’s office or at the grocery store or hospital.
3 (Not eligible … ) Use this option only if there’s a medical contraindication for the resident, including (but not limited to) an allergy to eggs or a previous adverse reaction to a flu vaccine.
4 (Offered and declined) The resident (or his legal representative or responsible party) has the right to refuse vaccination after being informed of the risks and benefits.
5 (Not offered)
6 (Inability to obtain influenza vaccine … ) Use this option if your facility cannot get enough doses due to a declared influenza vaccine shortage.
9 (None of the above) Code 9 if the answer isn’t listed here or if you cannot find out why the resident did not receive a vaccine.

Don’t forget: Although item O0250 (Influenza Vaccine) is the only place in the MDS that requires information specific to the influenza vaccine, you need to code it in Section N, too, if the resident receives the flu vaccine within the seven-day lookback period of the MDS assessment. For item N0300 (Injections), you are coding the number of days the resident receives “any type of medication, antigen, vaccine, etc. by subcutaneous, intramuscular, or intradermal injection,” per the RAI Manual.

Tricky: If the resident receives an influenza vaccine and a Vitamin B12 injection on Tuesday, and nothing else during the seven days, code N0300 “1”. But if the resident receives the influenza vaccine on Tuesday and a Vitamin B12 injection on Wednesday during the same seven-day lookback period, code N0300 “2.”

If the resident receives a flu vaccine elsewhere, like at his primary care physician’s office, during the seven-day lookback period, include it in your evaluation of N0300.