Question: One of the residents in the facility where I work needed a fentanyl patch during her seven-day lookback period. I know I code this as an opioid on the MDS, in item N0140H (Medications Received, Opioid), but I’m not sure how many days to mark. Please advise. New York Subscriber Answer: Good news: The RAI Manual is explicit in its guidance for this situation. “A transdermal patch is designed to release medication over a period of time (typically 3 – 5 days); therefore, transdermal patches would be considered long-acting medications for the purpose of coding the MDS, and only the days the staff attaches the patch to the skin are counted for the MDS. For example, if, during the 7-day look-back period, a fentanyl patch was applied on days 1, 4, and 7, N0410H Opioid would be coded 3, because the application occurred on 3 days during the look-back period,” the RAI Manual says, on page N-8.