MDS Alert

Find out if your facility is under- or overcoding ADLs.

Can nursing facilities count ADL assistance provided during rehab therapy or if the therapist, for example, goes to the bedside to assist the person to get up and go to the gym?

Be prepared to use new coding to report superbug MRSA. The Centers for Medicare & Medicaid Services has finalized the list of ICD-9-CM changes effective Oct. 1, which means you will need to make adjustments to the way you report Methicillin Resistant Staphylococcus Aureus (MRSA). Previously, when reporting a resident with MRSA, you would turn to V09.0 (Infection with microorganisms resistant to penicillins). But when the new ICD-9 codes become effective in October, this code will no longer represent MRSA. Instead, you'll choose from a variety of new and revised codes that indicate whether your resident's Staphylococcus aureus is methicillin resistant (MRSA) or methicillin susceptible (MSSA). You'll also have codes you can use to report residents with MRSA colonization.

When you have a diagnosis of MSSA or MRSA in conditions such as urinary tract infections, cellulitis, or osteomyelitis, you'll need to assign the code for the underlying infection first followed by the code to identify the organism as MSSA (041.11) or MRSA (041.12) as documented by the physician, says Charlotte Lefert, RHIA, an independent health information management consultant based in Madison, WI.

Ready to tackle another round of revised survey guidance? CMS recently released an advance copy of guidance for nutrition (F325) and sanitary conditions (F371), which go into effect on Sept. 1. For more information, read the CMS memo at http://www.cms.hhs.gov/SurveyCertificationGenInfo/PMSR/ItemDetail.asp?ItemID=CMS1213210.