MDS Alert

MDS News To Use

Have you checked out the January 2008 update to the RAI user's manual? The Centers for Medicare & Medicaid Services made numerous changes to various instructions. For coding urinary tract infection at I2j (p. 3-136), CMS added a sentence after the one that says UTI includes chronic and acute symptomatic infection(s) in the last 30 days. The added sentence reads: "Symptomatic refers to both chronic and acute infections; if symptoms are not present, do not code this item."

The update also revises the I3 title to include the following underlined verbiage within the parentheses: (7-day lookback except for all Quarterly Assessment forms which require a 90-day lookback).

Section K includes numerous changes, including:

K2a (p. 3-150): CMS has added the following sentence to the end of the coding section: "If a resident cannot stand to obtain a current height or is missing limbs, use another means of determining height per current standards of clinical practice."

K3 (p. 3-152): CMS has added the following as a third bullet point under clarifications: "MDS coding for items K3a and K3b captures the resident's weight at the 30-day and 180-day time points. K3a and K3b capture the resident's weight at these two distinct points in time only and note if there has been a weight loss or gain in either of those time periods."

For K3 (p. 3-152), CMS has removed the following sentence from the third paragraph in the third bullet point under clarifications: "For example, a 10 percent loss/gain within four months should also be coded here, and carefully evaluated."

Changes in Section M include a clarification in the introduction (p. 3-159) and for M4 (p. 3-165) that skin does not include eyes or oral mucosa. Surgical wounds (M4g) do not include "surgical wounds of the eyes or oral mucosa."

Download and read all of the changes at http://www.cms.hhs.gov/NursingHomeQualityInits/Downloads/MDS20Update200801.pdf.

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