Understanding and Coding MDS 3.0 Item K0710A3: Proportion of Calories Parenteral/Tube Feed -7 Days

Understanding and Coding MDS 3.0 Item K0710A3: Proportion of Calories Parenteral/Tube Feed – 7 Days

Introduction

Purpose:
For residents who are unable to consume food orally, tracking calorie intake through parenteral or tube feeding is essential for ensuring adequate nutrition. MDS Item K0710A3, Proportion of Calories Parenteral/Tube Feed – 7 Days, is used to document the percentage of a resident’s total caloric intake provided via parenteral nutrition or tube feeding over a 7-day period. Proper coding of this item helps healthcare professionals monitor the resident's nutritional status and adjust care plans as necessary. This article explains how to code MDS Item K0710A3 based on MDS 3.0 guidelines.

What is MDS Item K0710A3?

Explanation:
MDS Item K0710A3, Proportion of Calories Parenteral/Tube Feed – 7 Days, captures the percentage of a resident’s total caloric intake that was delivered through either:

• Parenteral nutrition (nutrition provided intravenously), or
• Tube feeding (such as through a gastrostomy or nasogastric tube) during the past 7 days.

This item is vital for residents who rely on non-oral feeding methods to meet their daily caloric needs, ensuring that their nutritional requirements are adequately met.

Guidelines for Coding K0710A3

Coding Instructions:
To correctly code Item K0710A3, follow these steps:

1. Review Nutritional Intake for the Past 7 Days:

   • Review the resident’s medical records to determine the amount of calories they received from parenteral nutrition or tube feeding over the last 7 days.

2. Calculate the Proportion of Calories from Parenteral/Tube Feeding:

   • Determine the total calories the resident received over the past 7 days, including both parenteral/tube feeding and any oral intake.
   • Divide the calories from parenteral nutrition or tube feeding by the total calories consumed to find the percentage of calories provided by these methods.

3. Code Based on the Proportion of Calories:

   • Code “1” if the resident received 25% or less of their total calories from parenteral nutrition or tube feeding.
   • Code “2” if the resident received 26% to 50% of their total calories from parenteral nutrition or tube feeding.
   • Code “3” if the resident received 51% to 75% of their total calories from parenteral nutrition or tube feeding.
   • Code “4” if the resident received 76% or more of their total calories from parenteral nutrition or tube feeding.

4. Enter the Response in Item K0710A3:

   • Based on the calculated percentage of caloric intake, select the appropriate code and enter it in K0710A3.

Example Scenario 1:
A resident received 3,000 calories from tube feeding over 7 days and an additional 1,000 calories orally. The total caloric intake for the 7-day period was 4,000 calories. The proportion of calories from tube feeding was 75% (3,000 ÷ 4,000 = 0.75). In this case, “3” would be entered in Item K0710A3 to reflect that 51% to 75% of the calories came from tube feeding.

Example Scenario 2:
A resident received 1,500 calories from parenteral nutrition and 3,500 calories orally during a 7-day period. The total caloric intake was 5,000 calories. The proportion of calories from parenteral nutrition was 30% (1,500 ÷ 5,000 = 0.30). In this case, “2” would be entered in Item K0710A3 to reflect that 26% to 50% of the calories came from parenteral nutrition.

Best Practices for Accurate Coding

Documentation:

• Accurately document the resident’s daily caloric intake from both parenteral nutrition or tube feeding and oral intake in their medical records.
• If the resident’s caloric needs or feeding methods change, document the reasons for these changes and update the care plan accordingly.

Communication:

• Share caloric intake information with the interdisciplinary care team, including dietitians, nurses, and physicians, to ensure the resident’s nutritional needs are met.
• Discuss any changes in the resident’s caloric intake or nutritional plan during care planning meetings to ensure appropriate interventions are implemented.

Nutritional Monitoring:

• Regularly monitor the resident’s nutritional status to ensure that they are receiving adequate calories and nutrients to support their overall health and well-being.
• Adjust the resident’s caloric intake as needed based on clinical assessments and recommendations from the dietitian or physician.

Conclusion

Summary:
MDS Item K0710A3 tracks the proportion of a resident’s caloric intake that is delivered through parenteral nutrition or tube feeding over a 7-day period. Accurate coding ensures that the resident’s nutritional needs are being properly met, especially for those who rely on non-oral feeding methods. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure effective nutritional management for residents in long-term care settings.

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 3-180] for detailed guidelines on coding parenteral and tube feeding calorie intake.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0710A3: Proportion of Calories Parenteral/Tube Feed – 7 Days 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.