Section K5 & P1c

Specialties Geriatric

Published

How are you coding the MDS if a pt. received 250mg of Vancomycin in 100cc NS TID?

Specializes in ER CCU MICU SICU LTC/SNF.

Hi Selena...

If you're giving the IV meds via a heplock, Section K5a (Parenteral/IV) does not apply. Code IV meds in Section P1c only.

If resident however has IV fluids as a primary line, even if it's running KVO, then you can check K5a and add the 100 cc TID diluent to the primary IVF intake in Section K6.

That is how we have been coding it, but the question keeps coming up. The rationale they are using is: If you can count KVO rate NS then you may only count 480cc of fluid intake. Yet if a pt. receives Vanco or something else in 250cc NS 4 x q day, the intake of NS would be 1000cc in 24 hours. You see what I'm saying? Looking at it from fluid intake, you are still getting that amount of fluid, irregardless if something is in it. Just curious what the general consensus was.

Thanks for your reply.

Specializes in ER CCU MICU SICU LTC/SNF.

You're precisely correct about the amount of IV fluid intake. For us clinicians, this item will remain non-sensical. The definition to Parenteral/IV in the MDS Manual, however, unless revised, shall be adhered to.

Hopefully, a brighter clinical person will have an input in the creation of the new revised MDS Manual.

:idea: :idea:

You are so right. I guess I have to keep that in mind. I am an MDS nurse consultant, I review MDS's for nursing homes before they submit them to state. We make corrections and recommendations trying to maxamize accuracy as well as reimbursement. Sometimes things like this makes it really aggravating.

But anyhow, thank you very much for your answer.

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