E0600B: Behavioral Symptoms Intrude on Privacy of Others, Step-by-Step

Step-by-Step Coding Guide for Item Set E0600B: Behavioral Symptoms Intrude on Privacy of Others

1. Review of Medical Records

• Objective: Accurately document if the resident displays behaviors that intrude on the privacy of others.
• Steps:
  1. Gather Information: Collect comprehensive medical records, including progress notes, behavioral assessments, care plans, and interdisciplinary team (IDT) notes.
  2. Identify Behavioral Incidents: Look for documented evidence of behaviors where the resident has intruded on the privacy of others.
  3. Confirm Details: Verify the consistency and accuracy of the behavior documentation across various sources within the medical records.

2. Understanding Definitions

• Behavioral Symptoms Intrude on Privacy of Others: This includes behaviors where the resident enters another person’s space without permission, invades personal boundaries, or engages in actions that disrupt others' privacy.
• Key Points:
  • Examples: Entering another resident’s room without permission, taking others’ belongings, or invading personal space.
  • Frequency: Document how often these behaviors occur and under what circumstances.

3. Coding Instructions

• Steps:
  1. Identify Relevant Documentation: Confirm through the medical records whether the resident exhibits behaviors intruding on others’ privacy.
  2. Verify Documentation: Ensure that the documentation clearly supports the occurrence and frequency of such behaviors.
  3. Code Appropriately: Enter the appropriate code for item set E0600B based on the documented behaviors:
     • 0: Behavior not exhibited.
     • 1: Behavior of this type occurred 1 to 3 days.
     • 2: Behavior of this type occurred 4 to 6 days, but less than daily.
     • 3: Behavior of this type occurred daily.

4. Coding Tips

• Accurate Identification: Ensure that behaviors intruding on privacy are correctly identified and supported by relevant documentation.
• Consistent Terminology: Use consistent terminology and phrasing when documenting and coding the behaviors.
• Clarify with the Interdisciplinary Team: If there is any uncertainty, clarify with the interdisciplinary team to ensure accurate coding.

5. Documentation

• Required:
  • Progress Notes: Detailed notes from healthcare providers documenting specific incidents of privacy intrusion.
  • Behavioral Assessments: Reports from behavioral assessments highlighting these behaviors.
  • Care Plans: Documentation of care plans addressing the management of these behaviors.
  • IDT Notes: Notes from interdisciplinary team meetings discussing the resident’s behaviors and related care planning.

6. Common Errors to Avoid

• Misclassification: Ensure accurate identification by verifying the behaviors through multiple records and observations.
• Incomplete Documentation: Make sure all relevant progress notes, behavioral assessments, and care plans are included to support the documented behaviors.
• Assumptions: Do not assume the behavior status without proper documentation and verification; always check multiple sources.

7. Practical Application

• Example:
  • Resident Profile: Sarah, a resident, has a history of entering other residents' rooms without permission.
  • Steps:
    1. Review Records: The nurse reviews Sarah’s medical records, noting multiple progress notes documenting instances of Sarah intruding on others’ privacy.
    2. Identify Behavior: It is confirmed through the documentation that Sarah enters other residents' rooms without permission at least 4 to 6 days a week.
    3. Document and Code: The nurse documents the behavior in Sarah’s records and codes E0600B as "2" (Behavior occurred 4 to 6 days, but less than daily).
  • Outcome: Sarah’s behaviors are accurately documented and coded, ensuring proper follow-up and care planning.

Please note that the information provided in this guide for MDS 3.0 Item set E0600B 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.