Test Your Knowledge

Test Your Knowledge Questions:

1) If the dietitian documents a resident is at risk of malnutrition, can I code this diagnosis on the MDS at item I5600? 

2) When a ​resident is admitted from the hospital with a diagnosis of UTI, there is supporting documentation from the physician and lab in the medical record, can I2300 be coded on the MDS?

3) Do diagnoses in Section I need to be prioritized? 

4) Can a resident under Medicare Part A who is receiving hospice care be covered at the same time, or does the resident need to disenroll from hospice first? 

5) What is required if a resident passes away the day after the ARD for a Significant Change in Status Assessment (SCSA) due to hospice initiation? 

6) If a resident dies unexpectedly during a Medicare Part A skilled stay, does an end of PPS MDS in addition to the Death in Facility need to be completed? 

7) Is melatonin a hypnotic medication that can be captured on the MDS? 

8) Coding J2100 Recent Surgery Requiring Active SNF Care

Scenario #1: A patient had back surgery in an acute care hospital, was discharged to an Inpatient Rehab Facility for a week or so, and was then discharged to an SNF for continued PT/OT. All of this took place within 30 days. Would this be coded as "yes" or no" for this question?

Scenario #2: Similar to scenario #1, except after discharging from the hospital, the patient was discharged to an SNF for a week, then transferred to another SNF. Would the second SNF code it as "yes" or "no"?

9) A LTC resident had a hospitalization for pneumonia and respiratory failure. The resident went back to the hospital on day 7 and a 5D/DRA/END OF PPS assessment was completed. The hospitalization lasted 3 midnights; however, day one of the stay was in observation, so technically only 2 midnights. The resident had surgery to have their pancreas removed and has returned. Should the end of PPS on the discharge be removed and continue his Medicare A stay, and complete an IPA, or complete a new 5D assessment starting a new stay? 

10) How to conduct Mood Interviews to get accurate responses:

An interview has to be coded as the resident answers, but what do you do when you have a resident with obvious signs/symptoms of depression and they respond with 'no' to all questions? Example: Resident cries every day due to missing family, has lost weight due to no appetite, and is up all night. But when the interview is conducted, the resident answers 'no' to all questions in Section D. Not only does this not show an accurate description of the resident, but we are also losing out on reimbursement. Or is there nothing we can do? Obviously, we are speaking with the physician and family on the issues the resident is having and attempting to help, but I need to know how to appropriately code on MDS.