Understanding and Coding MDS 3.0 Item K0520B2: Nutritional Approaches - Feeding Tube, Not a Resident

Understanding and Coding MDS 3.0 Item K0520B2: Nutritional Approaches – Feeding Tube, Not a Resident

Introduction

Purpose:
MDS Item K0520B2, Nutritional Approaches – Feeding Tube, Not a Resident, tracks whether an individual who is not a current resident of the facility is using a feeding tube. This item applies when a person has been evaluated or provided care at the facility but is not classified as a resident. Accurately coding this item ensures proper documentation of the individual’s nutritional needs. This article outlines the correct procedure for coding MDS Item K0520B2 based on MDS 3.0 guidelines.

What is MDS Item K0520B2?

Explanation:
MDS Item K0520B2 refers to individuals who are not residents of the facility but are receiving or have received nutrition via a feeding tube. A feeding tube provides essential nutrition to individuals who are unable to consume food orally due to medical conditions such as:

• Dysphagia (difficulty swallowing),
• Gastrointestinal disorders, or
• Severe malnutrition.

Feeding tubes can be of various types, including:

• Nasogastric (NG) tube,
• Gastrostomy (G-tube),
• Jejunostomy (J-tube).

Documenting the use of a feeding tube for non-residents is essential to track the care provided, even if the individual is not classified as a full-time resident.

Guidelines for Coding K0520B2

Coding Instructions:
To correctly code Item K0520B2, follow these steps:

1. Confirm the Individual’s Residency Status:

   • Ensure that the individual being assessed is not classified as a resident of the facility.
   • This item is used when a person has been evaluated or received care temporarily but is not a long-term or short-term resident.

2. Review Care Records for Feeding Tube Use:

   • Check the individual’s care plan and medical records to determine if a feeding tube was in use while receiving care at the facility.
   • Confirm that the feeding tube was part of the individual’s nutritional care during their interaction with the facility.

3. Code Based on Feeding Tube Use:

   • Code “1” for Feeding Tube – Not a Resident if the individual was using a feeding tube while receiving care or evaluation at the facility but was not classified as a resident.
   • If the individual was not using a feeding tube, leave this item unmarked.

4. Enter the Response in Item K0520B2:

   • If the non-resident individual received nutrition through a feeding tube, enter “1” in K0520B2.

Example Scenario 1:
A patient with gastrointestinal issues receives a consultation at the facility’s outpatient clinic and is using a nasogastric (NG) tube for nutrition. In this case, “1” would be entered in Item K0520B2 to reflect that the feeding tube was in use while the individual was receiving care but was not a resident.

Example Scenario 2:
An individual who visits the facility for evaluation but is not a resident has a gastrostomy (G-tube) in place for feeding. “1” would be entered in Item K0520B2 to document that the feeding tube was being used.

Best Practices for Accurate Coding

Documentation:

• Ensure the individual’s medical records clearly document the use of a feeding tube during their interaction with the facility, even if they are not classified as a resident.
• Record detailed information about the type of feeding tube used and the individual’s nutritional regimen.

Communication:

• Ensure that all relevant caregivers and healthcare professionals are informed about the individual’s feeding tube and nutritional requirements, even if they are not residents.
• Communicate the individual’s feeding tube care needs and any aftercare instructions to the individual and their caregivers.

Follow-Up and Monitoring:

• If the individual continues to use a feeding tube after leaving the facility, ensure that proper follow-up appointments are scheduled with their healthcare provider.
• Caregivers and family members should be educated on how to care for the feeding tube and monitor for complications, such as infection or blockage.

Conclusion

Summary:
MDS Item K0520B2 is used to document the use of a feeding tube for individuals who are not residents of the facility. Proper coding of this item ensures that the nutritional care provided to non-residents is tracked accurately. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure that non-resident individuals receiving care via a feeding tube have their nutritional needs properly documented and managed.

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 feeding tube use for non-residents.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520B2: Nutritional Approaches – Feeding Tube, Not 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.