Understanding and coding MDS Item I0500: Deep Venous Thrombosis (DVT), Pulmonary Embolism (PE), or Pulmonary Thromboembolism (PTE)

MDS Item I0500 – Deep Venous Thrombosis (DVT), Pulmonary Embolism (PE), or Pulmonary Thromboembolism (PTE)

Introduction

Deep venous thrombosis (DVT) and pulmonary embolism (PE) are serious, potentially life-threatening conditions that can occur in residents of long-term care facilities. MDS Item I0500 captures these diagnoses, helping healthcare providers monitor and treat these conditions effectively.

What is MDS Item I0500?

MDS Item I0500 documents whether the resident has a history of DVT, PE, or PTE. DVT involves the formation of blood clots in the deep veins, often in the legs, which can lead to serious complications if the clot breaks off and travels to the lungs, causing a pulmonary embolism. Prompt recognition and treatment are essential to prevent fatal outcomes.

Guidelines for Coding I0500

• Code 1: If the resident has a documented diagnosis of deep venous thrombosis (DVT), pulmonary embolism (PE), or pulmonary thromboembolism (PTE).
• Code 0: If the resident does not have a history of DVT, PE, or PTE.

Instructions:

• Review the resident’s medical history and confirm any diagnosis of DVT, PE, or PTE through physician notes, diagnostic tests, and treatments.

Example Scenario:

Resident B had a deep venous thrombosis diagnosed last year and is currently on anticoagulant therapy to prevent recurrence. Code 1 for MDS Item I0500.

Best Practices for Accurate Coding

• Documentation: Ensure DVT, PE, or PTE is clearly documented in the resident’s medical records, along with any anticoagulant therapy or other treatments.
• Monitoring: Regularly monitor residents at risk for DVT or PE, especially those who are immobile or post-surgery.
• Training: Train staff on recognizing symptoms of DVT and PE, such as leg swelling, pain, or sudden shortness of breath.

Conclusion

Accurately coding MDS Item I0500 ensures that residents with a history of DVT, PE, or PTE receive proper monitoring and treatment, preventing serious complications.

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, Chapter 3, Page I-9​.

Disclaimer:

Please note that the information provided in this guide for MDS 3.0 Item I0500 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.