D0150A1: PHQ Resident Mood Interview - Little Interest or Pleasure: Presence, Step-by-Step

Step-by-Step Coding Guide for D0150A1: PHQ Resident Mood Interview – "Little Interest or Pleasure: Presence"

1. Review of Medical Records

Objective: Assess the presence of the resident's symptom of little interest or pleasure in activities, part of the PHQ-9 screening for depression.

Actions:

• Review past assessments or notes indicating the resident's engagement in activities.
• Conduct the BIMS or PHQ-9 interview asking specifically if the resident has experienced little interest or pleasure in activities over the last two weeks.
• Record the resident's response, focusing on whether the symptom is present.

2. Understanding Definitions

D0150A1: Little Interest or Pleasure - Presence: This item assesses whether the resident has shown little interest or pleasure in activities over the last two weeks.

Example Scenarios:

• Resident A: States, "I haven't felt like doing much of anything recently." This would be coded as 1: Yes (symptom present).

3. Coding Instructions

Step-by-Step:

• Step 1: Ask the resident, “Over the last two weeks, have you been bothered by little interest or pleasure in doing things?”
• Step 2: Based on the resident’s response, code as follows:
  • 1: Yes – If the resident confirms that they experienced little interest or pleasure.
  • 0: No – If the resident denies the symptom or expresses no change in interest or pleasure.
  • 9: No response – If the resident is unable or unwilling to answer.

4. Coding Tips

• Neutral Probing: If the resident gives a vague or unclear response, gently ask follow-up questions like, “Can you tell me more about that?”
• No Assumptions: Code based solely on the resident's self-report without assuming from observations alone.

5. Documentation

Objective: Record whether the resident has experienced little interest or pleasure in activities to assist in identifying potential depression symptoms.

Actions:

• Document the resident’s answer clearly in the medical records.
• If the symptom is present, ensure that further follow-up is included in the care plan.

6. Common Errors to Avoid

• Skipping the Interview: Always attempt to interview the resident before deciding to code based on observations or other records.
• Coding Without Confirmation: Do not assume the presence of the symptom without a clear response from the resident.

7. Practical Application

Example 1:
A resident reports feeling uninterested in activities they usually enjoy, such as group meals and games. This should be coded as 1: Yes for D0150A1.

Example 2:
Another resident denies feeling any change in interest or pleasure in activities. This should be coded as 0: No.

Please note that the information provided in this guide for MDS 3.0 Item set D0150A1 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.