coding for tube feeding... yes, again!

[crazyforthis]

My question is about tube feeding. We have a patient that was admitted with a new peg site (among other things) and tube feeding regime. He was getting bolused TF's and was expected to continue the practice once discharged home. On day 16 of his stay in our SNF Nursing began to teach the patient how to care for peg site and give own tube feeds. On day 24 the patient was giving his own tube feeds at each scheduled bolus time. The formula was brought to his room by nursing from our on unit 'kitchen' each time he needed it. While doing his 30 day PPS I noticed that some nursing staff was coding in the eating section as 0/0 and some were coding it as 4/2. Upon speaking with the nursing staff they all agreed that they were bringing the TF to room for patient to give his own bolus feeds. He had no other nutritional intake. Nursing also agreed they were all assessing PEG site for s/sx of infection, leaking, displacement and asking patient how he felt he was tolerating the TF's. But none were actually setting up and giving the TF. In this case, what would be the proper coding for the eating section? Thank you

[SRK77]

Since the pt is skilled, I would think supervision at minimum.

[Mauves08]

I agree with SRK. Especially since the tube feedings are new, you should reflect that your staff is, at the very least, supervising these which includes the education as well. When our patients are at that point in their rehabilitation, I generally code it as 1/1. Hope this helps!