Understanding and Coding MDS 3.0 Item K0520A3: Nutritional Approaches - Parenteral/IV Feeding While a Resident

Understanding and Coding MDS 3.0 Item K0520A3: Nutritional Approaches – Parenteral/IV Feeding While a Resident

Introduction

Purpose:
MDS Item K0520A3, Nutritional Approaches – Parenteral/IV Feeding While a Resident, documents whether a resident was receiving parenteral or intravenous (IV) feeding during their stay in the facility. Parenteral/IV feeding is used to provide nutrition when the resident is unable to use their gastrointestinal tract to absorb nutrients. Proper coding of this item ensures that the resident’s nutritional needs are accurately tracked and documented, helping the care team provide appropriate interventions. This article explains how to code MDS Item K0520A3 based on the MDS 3.0 guidelines.

What is MDS Item K0520A3?

Explanation:
MDS Item K0520A3 applies to residents who received parenteral or IV feeding at any time during their stay in the facility. This method is used for residents who cannot meet their nutritional requirements through oral or enteral feeding. Parenteral/IV feeding includes:

• Total Parenteral Nutrition (TPN),
• Peripheral Parenteral Nutrition (PPN).

Parenteral/IV feeding delivers nutrients directly into the bloodstream and is critical for residents with severe digestive issues or other conditions that prevent normal nutrient absorption.

Guidelines for Coding K0520A3

Coding Instructions:
To accurately code Item K0520A3, follow these steps:

1. Review the Resident’s Care Plan and Medical Records:

   • Check the resident’s care plan and medical records to confirm whether they were receiving parenteral or IV feeding at any time during their stay in the facility.

2. Confirm Parenteral/IV Feeding Use:

   • Ensure that parenteral or IV feeding was used for nutrition, fluids, or medication as part of the resident’s care regimen during their residency.

3. Code Based on Parenteral/IV Feeding Use:

   • Code “1” for Parenteral/IV Feeding While a Resident if the resident received parenteral or IV nutrition during any part of their stay.
   • If the resident did not receive parenteral/IV feeding while in the facility, leave this item unmarked and code the appropriate nutritional approach.

4. Enter the Response in Item K0520A3:

   • If the resident received parenteral/IV feeding, enter “1” in K0520A3.

Example Scenario 1:
A resident with gastrointestinal issues was placed on Total Parenteral Nutrition (TPN) to receive their nutrients intravenously during their stay. In this case, “1” would be entered in Item K0520A3 to document the use of parenteral/IV feeding.

Example Scenario 2:
A resident recovering from surgery was unable to eat and was placed on Peripheral Parenteral Nutrition (PPN) for nutritional support during their recovery. In this case, “1” would be entered in K0520A3 to indicate the use of parenteral/IV feeding.

Best Practices for Accurate Coding

Documentation:

• Ensure that the resident’s medical records include detailed information on the type of parenteral/IV feeding used, the reason for its use, and the feeding regimen.
• Record any adjustments to the feeding plan or complications that arose during the resident’s stay.

Communication:

• Inform the interdisciplinary care team, including nurses, dietitians, and physicians, about the resident’s nutritional needs and parenteral/IV feeding regimen.
• Ensure that all staff are aware of how to properly manage the feeding and recognize signs of complications, such as infections at the catheter site or metabolic issues.

Monitoring and Follow-Up:

• Regularly monitor the resident’s response to the parenteral/IV feeding and adjust the care plan as needed.
• Follow up with healthcare providers, including dietitians and physicians, to ensure the resident’s nutritional needs are being met and to address any complications related to parenteral feeding.

Conclusion

Summary:
MDS Item K0520A3 is used to document whether a resident received parenteral or IV feeding during their stay in the facility. Proper coding ensures that the resident’s nutritional requirements are accurately documented and that their care plan is designed to meet their specific needs. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure appropriate documentation and care for residents who require parenteral or IV feeding.

Click here to see a detailed step-by-step on how to complete this item set

Reference

CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. Refer to [Chapter 3, Page 3-184] for detailed guidelines on coding parenteral or IV feeding use during residency.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520A3: Nutritional Approaches – Parenteral/IV Feeding While a Resident was originally based on the CMS's Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024. 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.