E0600A: Behavioral Symptoms Put Others at Risk for Injury, Step-by-Step

Step-by-Step Coding Guide for Item Set E0600A: Behavioral Symptoms Put Others at Risk for Injury

1. Review of Medical Records

• Objective: To accurately identify any documented behavioral symptoms that put others at risk for injury.
• Process:
  • Examine behavior tracking logs and nursing notes for instances of aggressive or unsafe behaviors directed towards others.
  • Review incident reports and staff statements concerning the resident's behavior.
  • Consult with the care team, including psychologists or psychiatrists who have assessed or treated the resident.

2. Understanding Definitions

• Behavioral Symptoms That Put Others at Risk for Injury: Includes any physical or verbal actions by the resident that could potentially cause physical harm to others. This may involve hitting, biting, pushing, throwing objects, or threats that lead to actual or potential physical impacts.

3. Coding Instructions

• Code E0600A:
  • 0: No known behavior putting others at risk.
  • 1: Known behavior that puts others at risk was exhibited.
• Example: If a resident has been documented trying to hit a caregiver, code E0600A as '1'.

4. Coding Tips

• Distinguish between behaviors that are harmful versus those that are non-threatening.
• Regularly update coding if behavioral patterns change or new incidents occur.

5. Documentation

• Required Documentation:
  • Detailed descriptions of the behavior, including the context and potential triggers.
  • Records of interventions used and their outcomes.
  • Statements from witnesses or staff directly involved in incidents.
• Ensure all incidents are documented promptly and comprehensively.

6. Common Errors to Avoid

• Overlooking verbal threats that have the potential to escalate into physical harm.
• Confusing general noncompliance or agitation with behaviors that specifically endanger others.
• Failing to update the resident’s record when new behavioral issues arise or existing ones are resolved.

7. Practical Application

• Scenario: During a group activity, a resident becomes agitated and throws a chair in the direction of other residents, nearly causing injury. The incident is immediately reported by staff, and detailed in the resident’s behavior log. Interventions are documented, including de-escalation techniques and consultation with a behavioral specialist. In MDS coding, this event is captured under E0600A as '1', reflecting the risk posed by the resident’s actions.

Please note that the information provided in this guide for MDS 3.0 Item set E0600A 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.