Understanding and Coding MDS 3.0 Item M1200B: Skin/Ulcer Treatments - Pressure Reducing Device for Bed

Introduction

Purpose:
The use of pressure-reducing devices, particularly in bed-bound residents, is a crucial intervention for preventing and managing pressure ulcers. These devices help reduce pressure on vulnerable areas of the body, such as the sacrum, hips, and heels, thereby promoting circulation and preventing skin breakdown. MDS Item M1200B, Skin/Ulcer Treatments - Pressure Reducing Device for Bed, is used to document whether a pressure-reducing device was used in bed to manage or prevent pressure ulcers. Accurate coding of this item ensures compliance with CMS guidelines and helps track the appropriate use of these devices in long-term care settings. This article provides detailed guidance on how to correctly code this item based on the latest MDS 3.0 standards.

What is MDS Item M1200B?

Explanation:
MDS Item M1200B, Skin/Ulcer Treatments - Pressure Reducing Device for Bed, records whether a pressure-reducing device, such as a special mattress, mattress overlay, or air-fluidized bed, was used in the resident's bed during the assessment period. These devices are designed to relieve pressure on areas susceptible to skin breakdown, especially for residents who are immobile or spend extended time in bed. The goal of using these devices is to prevent the development or progression of pressure ulcers and to promote healing of existing pressure injuries.

This item ensures that the use of pressure-reducing devices is documented and that residents at risk of pressure ulcers are receiving appropriate preventive care.

Guidelines for Coding M1200B

Coding Instructions:
To correctly code Item M1200B, follow these steps:

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

   • Verify that a pressure-reducing device was used in the resident’s bed to prevent or treat pressure ulcers during the assessment period. Devices may include foam mattresses, gel overlays, or low-air-loss mattresses.

2. Determine if a Pressure-Reducing Device Was Used:

   • Code “0” if no pressure-reducing device was used in the bed during the assessment period.
   • Code “1” if a pressure-reducing device was used in the bed during the assessment period.

3. Enter the Response in Item M1200B:

   • Record “1” if a pressure-reducing device was used in the bed during the assessment period. If no device was used, record “0.”

Example Scenario:
A resident with a history of pressure ulcers is placed on a low-air-loss mattress to reduce pressure on the sacral area while in bed. The mattress is used consistently throughout the assessment period to prevent further skin breakdown. In this case, 1 would be entered in Item M1200B to indicate that a pressure-reducing device was used. If no pressure-reducing device was provided during the assessment period, 0 would be entered.

Best Practices for Accurate Coding

Documentation:

• Ensure that the use of pressure-reducing devices is documented in the resident’s medical records, including the type of device used and its purpose (e.g., prevention or treatment of pressure ulcers).
• Regularly assess the resident’s skin condition and document any changes, including improvements or worsening of pressure ulcers, to evaluate the effectiveness of the pressure-reducing device.

Communication:

• Maintain open communication between nurses, physicians, and wound care specialists to ensure that the resident’s use of pressure-reducing devices is properly coordinated and documented.
• Discuss the resident’s pressure-reducing device usage during care planning meetings to ensure the care plan is aligned with the resident’s needs for pressure ulcer prevention and treatment.

Regular Audits:

• Conduct regular audits of care records to ensure that the use of pressure-reducing devices is accurately documented, particularly for residents at high risk of skin breakdown.
• Review care plans regularly to ensure that pressure-reducing devices are being used appropriately and that residents are being assessed for the ongoing need for such devices.

Conclusion

Summary:
MDS Item M1200B is critical for documenting whether a pressure-reducing device was used in the resident’s bed during the assessment period. Proper coding of this item ensures that residents at risk of pressure ulcers are receiving appropriate preventive care and that the use of pressure-reducing devices is accurately tracked. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure optimal care for residents at risk of skin breakdown 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 3-167] for detailed guidelines on documenting the use of pressure-reducing devices for skin/ulcer treatments.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item M1200B: Skin/Ulcer Treatments - Pressure Reducing Device for Bed 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.