A1250A: Transportation - Yes, kept from medical appointments, Step-by-Step

Step-by-Step Coding Guide for A1250A: Transportation – "Yes, kept from medical appointments"

1. Review of Medical Records

Objective: Determine if the resident's lack of transportation has prevented them from attending medical appointments or obtaining medications in the past six months to a year.

Actions:

• Review the resident's care plan and records for any documented transportation barriers.
• Directly ask the resident if, in the past six months to a year, transportation issues have kept them from medical appointments or obtaining medications.
• If the resident cannot respond, interview family members, caregivers, or legally authorized representatives.

2. Understanding Definitions

A1250A: Transportation (Yes, kept from medical appointments) captures whether the resident has experienced difficulties in accessing medical care due to transportation issues. This includes medical appointments, therapy, or obtaining necessary medications.

Example Scenario:

• Resident A: The resident reports that they were unable to attend physical therapy due to a lack of transportation. This would be coded as A1250A: Yes.

3. Coding Instructions

Step-by-Step:

• Step 1: Ask the resident if they have been kept from medical appointments or obtaining medications due to transportation issues.
• Step 2: If they confirm this occurred, select A1250A: Yes.
• Step 3: If the resident cannot respond, rely on family input or medical records, and document as X: Resident unable to respond if no answer is available.

4. Coding Tips

• Multiple Transportation Barriers: If the resident mentions both medical and non-medical barriers due to transportation, ensure that A1250A captures the medical aspect, while A1250B would address non-medical issues.
• Unable to Respond: If the resident cannot provide an answer and family members or medical records are insufficient, code X: Resident unable to respond.

5. Documentation

Objective: Record the resident’s transportation limitations, ensuring accurate care planning and coordination for future appointments.

Actions:

• Clearly document the barriers to transportation that affected medical appointments, including dates or specifics.
• Ensure that the resident’s care plan addresses any recurring transportation challenges, such as arranging future transport.

6. Common Errors to Avoid

• Assuming Barriers: Do not assume the resident has transportation barriers without directly asking or reviewing documented information.
• Incomplete Reporting: Ensure that both medical and non-medical transportation barriers are appropriately coded, with clear distinctions between A1250A and A1250B.

7. Practical Application

Example 1:
A resident states they missed several doctor appointments because they could not arrange transportation. This would be coded as A1250A: Yes.

Example 2:
A resident's family confirms they always provide transportation, and there have been no issues. This would be coded as A1250A: No.

Please note that the information provided in this guide for MDS 3.0 Item set A1250A was originally based on the CMS's RAI Version 3.0 Manual, October 2023 edition. Every effort will be made to update it to the most current version. The MDS 3.0 Manual is typically updated every October. If there are no changes to the Item Set, there will be no changes to this guide. This guidance is intended to assist healthcare professionals, particularly new nurses or MDS coordinators, in understanding and applying the correct coding procedures for this specific item within MDS 3.0.  

The guide is not a substitute for professional judgment or the facility’s policies. It is crucial to stay updated with any changes or updates in the MDS 3.0 manual or relevant CMS regulations. The guide does not cover all potential scenarios and should not be used as a sole resource for MDS 3.0 coding.  

Additionally, this guide refrains from handling personal patient data and does not provide medical or legal advice. Users are responsible for ensuring compliance with all applicable laws and regulations in their respective practices.