Step-by-Step Coding Guide for Item Set A2000: Discharge Date

1. Review of Medical Records

• Objective: To accurately determine and record the resident’s discharge date from the facility.
• Process:
  • Examine the discharge planning documentation and discharge summaries within the resident’s medical records.
  • Confirm the discharge date by reviewing nursing notes, physician orders, and administrative records noting the resident’s official release.
  • Cross-reference with billing department records to ensure consistency regarding the discharge date.

2. Understanding Definitions

• Discharge Date: Refers to the calendar date on which the resident was officially discharged from the facility, terminating residential care.

3. Coding Instructions

• Code A2000:
  • Enter the date (Month-Day-Year) on which the resident was formally discharged from the facility.
• Example: If a resident was discharged on March 5, 2024, enter 03/05/2024 in A2000.

4. Coding Tips

• Always use two digits for the month and day and four digits for the year to maintain the standard date format.
• Double-check the date for accuracy before entering it into the MDS to avoid discrepancies.

5. Documentation

• Required Documentation:
  • Discharge summary that includes the discharge date.
  • Physician’s discharge order specifying the release date.
  • Administrative checkout forms that log the date when the resident left the facility.
• Ensure that all documents consistently reflect the same discharge date.

6. Common Errors to Avoid

• Recording a date that does not match the documented discharge date in the discharge summary and physician orders.
• Failing to update the MDS if discharge plans change last minute.
• Miscommunication between clinical and administrative records leading to incorrect dates being reported.

7. Practical Application

• Scenario: A resident planned to be discharged on April 10, 2024. The interdisciplinary team prepared all discharge documents, including a summary and physician orders, for April 10. However, due to a change in the resident’s condition, the discharge was postponed to April 12, 2024, which was documented in an updated physician order and communicated to all relevant departments. The MDS coordinator then correctly records the discharge date as 04/12/2024 in item A2000, ensuring all supporting documentation is consistent.

Please note that the information provided in this guide for MDS 3.0 Item set A2000 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, this guide will not be changed. 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.