MDS Alert
MDS, Billing & Clinical News To Use
Check out the updated Beers list of potentially dangerous drugs for older adults. An expert panel has updated the widely used 1997 Beers criteria for avoiding potentially harmful medications in older adults.
The criteria address two situations: (1) Medications that should generally be avoided in persons 65 years and older because they are ineffective or pose unnecessarily high risk and safer alternatives exist; and (2) medications that should not be used in older persons known to have specific medical conditions.
The 1997 version provided the basis for existing survey guidelines directing nursing facilities to generally avoid prescribing certain drugs with a higher risk of adverse drug reactions without a risk-benefit analysis and monitoring.
Medications added to the updated Beers list include: estrogen in older women; conventional antipsychotic drugs in people with Parkinson's disease; decongestants in people with bladder flow obstructions; anticholinergics in patients with urinary incontinence; and non-COX selective NSAIDs. To review the changes, go to http://archinte.ama-assn.org/cgi/content-nw/full/163/22/2716/TABLEIOI20821T3.
The updated Beers criteria won't automatically affect the existing survey guidelines based on the 1997 version. "CMS would have to go through a process to change what's in place now," says Sam Kidder, PharmD, a long-term care ombudsman in Silver Spring, MD. "Providers can, however, use the updated Beers criteria as a best practice standard," he suggests.
Are you using the 2004 ICD-9-CM codes that went into effect Jan. 1? Your facility can't file clean claims using outdated diagnosis codes. So print the new codes at http://www.cms.hhs.gov/medlearn/tab6a03.pdf as a reference for the MDS team and billing.
The top four new codes affecting long-term care include:
Source: Centers for Disease Control & Prevention.
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