Understanding and Coding MDS 3.0 Item M1200C: Skin/Ulcer Treatments - Turning/Repositioning

Understanding and Coding MDS 3.0 Item M1200C: Skin/Ulcer Treatments - Turning/Repositioning

Introduction

Purpose:
Turning and repositioning are essential preventive measures in the care of residents who are at risk of developing pressure ulcers or skin breakdown. These interventions help to relieve pressure on vulnerable areas of the body, improving circulation and promoting skin integrity. MDS Item M1200C, Skin/Ulcer Treatments - Turning/Repositioning, is used to document when these interventions are implemented during the assessment period. Proper coding of this item ensures compliance with CMS guidelines and ensures that residents receive the necessary care to prevent or treat skin issues. This article provides detailed guidance on how to correctly code this item based on the MDS 3.0 standards.

What is MDS Item M1200C?

Explanation:
MDS Item M1200C, Skin/Ulcer Treatments - Turning/Repositioning, tracks whether a resident received scheduled turning or repositioning during the assessment period. This intervention is often part of a skin and ulcer prevention or treatment plan, particularly for residents who are immobile, bed-bound, or at risk of developing pressure ulcers. Regular turning and repositioning help to relieve pressure on certain areas of the body, preventing the development of pressure injuries and promoting healing for residents with existing skin breakdown.

This item ensures that residents at risk of pressure ulcers are receiving appropriate preventive care.

Guidelines for Coding M1200C

Coding Instructions:
To correctly code Item M1200C, follow these steps:

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

   • Confirm that scheduled turning or repositioning was implemented to prevent skin breakdown or treat existing pressure ulcers during the assessment period.

2. Determine if Turning/Repositioning Was Provided:

   • Code “0” if no turning or repositioning interventions were provided during the assessment period.
   • Code “1” if the resident received regular turning or repositioning as part of their care plan to manage or prevent skin breakdown during the assessment period.

3. Enter the Response in Item M1200C:

   • Record “1” if turning or repositioning interventions were provided. If no turning or repositioning was administered during the assessment period, enter “0.”

Example Scenario:
A resident who is bed-bound is placed on a two-hour turning schedule to prevent pressure ulcers. During the assessment period, nursing staff reposition the resident every two hours as part of the care plan. In this case, 1 would be entered in Item M1200C to indicate that regular turning and repositioning were provided. If the resident did not receive these interventions during the assessment period, 0 would be entered.

Best Practices for Accurate Coding

Documentation:

• Ensure that all turning and repositioning interventions are documented in the resident’s care plan, including the frequency and method of repositioning.
• Record any changes in the resident’s skin condition, including improvements or the development of pressure ulcers, to evaluate the effectiveness of turning and repositioning interventions.

Communication:

• Collaborate with the interdisciplinary care team, including nurses, physical therapists, and physicians, to ensure that turning and repositioning interventions are part of the resident’s care plan and are properly implemented and documented.
• Discuss the resident’s turning/repositioning plan during care planning meetings to ensure consistency in care and to adjust the schedule as needed based on the resident’s skin condition.

Regular Audits:

• Conduct regular audits of care records to verify that scheduled turning and repositioning are being carried out according to the care plan.
• Review the resident’s care plan regularly to ensure that turning and repositioning schedules are updated as needed and that residents at risk of skin breakdown receive appropriate care.

Conclusion

Summary:
MDS Item M1200C is essential for documenting whether turning and repositioning interventions were provided during the assessment period. Proper coding of this item ensures that residents at risk of pressure ulcers or skin breakdown receive the necessary preventive care, helping to improve skin integrity and prevent complications. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure accurate documentation and optimal care 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 3-167] for detailed guidelines on documenting turning and repositioning interventions for skin/ulcer treatments.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item M1200C: Skin/Ulcer Treatments - Turning/Repositioning 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.