Understanding and Coding MDS Item I7900: "None of the Above Active Diagnoses within Last 7 Days"

Introduction

Purpose:
MDS Item I7900, "None of the Above Active Diagnoses within Last 7 Days," is used to document when none of the listed active diagnoses apply to the resident during the look-back period. Accurately completing this item ensures that the resident’s MDS assessment reflects the correct health status and avoids including irrelevant diagnoses in the care plan.

What is MDS Item I7900?

Explanation:
MDS Item I7900 is part of the Section I series in the MDS 3.0 assessment that captures a resident’s active diagnoses. This specific item is used when none of the diagnoses listed in the prior sections (I0100 through I8000) are active or relevant to the resident during the look-back period (typically 7 days). Essentially, if the resident does not have any active conditions affecting their care that are listed in the prior diagnosis sections, you would select I7900.

• Relevance: This item ensures that the care plan reflects the resident’s accurate health status by avoiding unnecessary diagnoses that do not impact the resident’s care during the look-back period.
• Importance: Proper coding of I7900 ensures that care resources are allocated appropriately and that the resident’s medical records remain accurate, helping to inform treatment decisions and monitor the resident’s health.

Guidelines for Coding MDS Item I7900

Coding Instructions:

1. Review Previous Diagnoses:
   Before coding I7900, review all previous items in Section I (I0100 through I8000) to ensure that no active diagnoses were identified during the look-back period. The resident should have no active conditions requiring treatment, monitoring, or assessment during the last 7 days.

2. Confirm the Lack of Active Diagnoses:
   If none of the diagnoses listed in the previous items are actively affecting the resident’s care, you will code I7900 to indicate that none of the above diagnoses apply.

3. Answering I7900:

   • Code 1 (Yes) if none of the diagnoses listed in Section I (I0100 through I8000) were active during the last 7 days.
   • Code 0 (No) if at least one of the diagnoses in the prior items was active during the look-back period. In this case, you should have coded the relevant diagnoses in the earlier sections.

4. Documentation Requirements:
   Ensure that the absence of active diagnoses is supported by the resident’s medical record. Review the documentation from the look-back period to confirm that no conditions were treated, monitored, or assessed during this time.

5. Verification:
   Verify the accuracy of I7900 by reviewing the resident’s treatment records, progress notes, and care plans. Confirm that the resident’s care does not require ongoing attention to any conditions listed in Section I.

Example Scenario:
Mr. Adams, a 68-year-old resident, has no active medical conditions requiring treatment, monitoring, or care during the look-back period. His past diagnoses of hypertension and diabetes have been well-controlled, and no interventions were needed over the last 7 days. In this case, code 1 (Yes) for I7900 to indicate that none of the previously listed diagnoses apply.

Best Practices for Accurate Coding

Documentation:
Ensure that the absence of active diagnoses is clearly documented in the resident’s medical record. Regularly review the resident’s care documentation to confirm that no new or ongoing conditions have arisen that would need to be included in Section I.

Communication:
Work closely with the interdisciplinary care team to confirm that no active conditions require attention. Collaboration helps avoid errors in coding and ensures that the care plan reflects the resident’s current health status.

Training:
Provide training to staff on how to correctly identify active diagnoses and when to use I7900. Staff should understand that I7900 is only used when no active diagnoses from the previous sections are relevant to the resident’s care during the look-back period.

Conclusion

MDS Item I7900 is crucial for documenting when a resident has no active diagnoses affecting their care during the look-back period. Accurate coding ensures that the MDS assessment reflects the resident’s current health status and prevents the inclusion of irrelevant diagnoses. Proper documentation, communication, and staff training are essential to ensure accurate use of this item.

Click here to see a detailed step-by-step on how to complete this item set 

Reference

For more detailed guidelines on coding MDS Item I7900, refer to the CMS’s Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.19.1, October 2024, Chapter 3, Section I, Page 3-97.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item I7900: "None of the Above Active Diagnoses within Last 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.