coding combo meds

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Specializes in MDS Coordinator.

I have a resident on Prinzide, which is a combination of Lisinopril and HCTZ. Our pharmacy tells us that it's actual classification is antihypertensive. But should we still be coding it in section "O" (diuretic) since it does have a diuretic in it? Seems like everyone I ask has a different opinion here!

Thanks!

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Specializes in ER CCU MICU SICU LTC/SNF.

It is 2 drugs w/ 2 different actions simply put together into one convenient tablet. The effects of each still exist.

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Check with your state guru. I was told (by our guru) to code the meds for the "classification"- thus would not code as diuretic. Does not make sense to me, I agree. I saved the e-mail for proof should state guestion my coding. and all MDS staff in our building also code meds this way.

Your guru should be listed on CMS site. I'm lucky, we subscribe to Briggs, so always have updates (maybe not always timley but eventaully) and it also lists the MDS contact state by state.

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Specializes in ER CCU MICU SICU LTC/SNF.

"prinzide is composed of two kinds of drugs, lisinopril and hydrochlorothiazide. lisinopril is an angiotensin converting enzyme (ace) inhibitor that inhibits an enzyme that causes tightening of blood vessels, thus allow the blood pressure to fall with the widening of blood vessels. hydrochlorothiazide is a diuretic that then acts on the kidneys to purge the excess water and salt in the body, further lowering the blood pressure."

since hctz is present in the drug, why should it be excluded in coding as a diuretic?

'am sure the issue you've asked your state rai coordinator is not about a combination of 2 different drugs but rather what the rai already explained, clarification, p3-180 - "code medications according to a drug's pharmacological classification, not how it is used. for example, oxazepan (serax) may be used as a hypnotic, but it is classified as an antianxiety. serax would be coded as an antianxiety." same case w/ vistaril. just because it is prescribed for pruritus does not mean it should not be coded as antianxiety.

glenda would have raised the question had it been the case of prinzide.

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