J0850: Frequency of Indicator of Pain or Possible Pain

J0850: Frequency of Indicator of Pain or Possible Pain

Item Rationale

Health-related Quality of Life

• Unrelieved pain adversely affects function and mobility contributing to dependence, skin breakdown, contractures, and weight loss.

• Pain significantly adversely affects a person’s quality of life and is tightly linked to depression, diminished self-confidence and self-esteem, as well as to an increase in behavior problems, particularly for cognitively impaired residents.

Planning for Care

• Assessment of pain frequency provides:

— A basis for evaluating treatment need and response to treatment.

— Information to aide in identifying optimum timing of treatment.

Steps for Assessment

1. Review medical record and interview staff and direct caregivers to determine the number of days the resident either complained of pain or showed evidence of pain as described in J0800 in the last 5 days.

Coding Instructions

Code for pain frequency in the last 5 days.

• Code 1: if based on staff observation, the resident complained or showed evidence of pain 1 to 2 days.

• Code 2: if based on staff observation, the resident complained or showed evidence of pain 3 to 4 days.

• Code 3: if based on staff observation, the resident complained or showed evidence of pain on a daily basis.

Examples

1. Resident M is an 80-year-old individual with advanced dementia. During the last 5 days, Resident M was noted to be grimacing and verbalizing “ouch” over the past 2 days when their right shoulder was moved.

Coding: Item J0850 would be coded 1, indicators of pain observed 1 to 2 days.

Rationale: They have demonstrated vocal complaints of pain (“ouch”), facial expression of pain (grimacing) on 2 of the last 5 days.

2. Resident C is a 78-year-old individual with a history of CVA with expressive aphasia and dementia. In the last 5 days, the resident was noted on a daily basis to be rubbing theirright knee and grimacing.

Coding: Item J0850 would be coded 3, indicators of pain observed daily.

Rationale: The resident was observed with a facial expression of pain (grimacing) and protective body movements (rubbing their knee) every day in the last 5 days.