Scheduled pain meds

Specialties MDS

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Specializes in ICU, Hospice, Radiology, MDS.

Hi everyone! I'm wondering about the use of methadone for substance abuse - in a resident with pain, do you code as a scheduled pain med? Thanks

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Specializes in Clinical Documentation Specialist, LTC.
Hi everyone! I'm wondering about the use of methadone for substance abuse - in a resident with pain, do you code as a scheduled pain med? Thanks

It is my understanding that a medication is coded as what it is prescribed for, so you would not code Methadone as a scheduled pain med. unless the order states it is for pain. For example; Say you have a resident with an order for Remeron for sleep. It would be coded as a sleep aid, not as an antidepressant.

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Hi everyone! I'm wondering about the use of methadone for substance abuse - in a resident with pain, do you code as a scheduled pain med?

Your question answered itself- you indicated the med is ordered 'for substance abuse'. If the MDS indicates there is pain, the order for the Methadone might simply be clarified to be used for 'narcotic addiction maintenance and pain', even better if both conditions were further specified and/or clarified. With a possibly vague order or indication (one condition or the other) I'd be suprised if the pharmacy, if nobody else, wasn't asking a lot of questions.

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Specializes in Care Coordination, MDS, med-surg, Peds.

LTCNS:

You are incorrect about how to classify a medication. Check out RAI manual page N-5-6:

:• Code medications in Item N0410 according to the

medication’s therapeutic category and/or

pharmacological classification, not how it is used.

For example, although oxazepam may be

prescribed for use as a hypnotic, it is categorized as

an antianxiety medication. Therefore, in this

section, it would be coded as an antianxiety medication and not as a hypnotic.

So in your example with remeron, it is correctly classed as an anti-depressant NO MATTER how it is used..

.

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Good point about the manual, I haven't seen one in a while. OP: Is the Remeron ordered for depression, is there a diagnosis of depression, or is it ordered solely for insomnia without depression? Notwithstanding the coding issue, if a med is used for other than its usual or supposed reason, it can lead to conflicting documentation all over the place, MDS included. For example, what if a surveyor asked 'is this patient depressed', one nurse may say no- that med is only used for insomnia (but there may or may not be a diagnosis of depression)- or another nurse may say 'yes- and her depression is manifested by insomnia', and the social worker may something totally different, etc. Stuff like this actually just leads to more work, when a properly worded med order can prevent a lot of that, not just in regards to the MDS. There's not much more annoying than constantly having to call to clarify med order, after med order, after med order...

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Specializes in Clinical Documentation Specialist, LTC.
LTCNS:

You are incorrect about how to classify a medication. Check out RAI manual page N-5-6:

:• Code medications in Item N0410 according to the

medication’s therapeutic category and/or

pharmacological classification, not how it is used.

For example, although oxazepam may be

prescribed for use as a hypnotic, it is categorized as

an antianxiety medication. Therefore, in this

section, it would be coded as an antianxiety medication and not as a hypnotic.

So in your example with remeron, it is correctly classed as an anti-depressant NO MATTER how it is used..

.

You are right. I had it backwards. Sorry for the misinformation :blink:

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