K0710: Percent Intake by Artificial Route

 Complete K0710 only if Column 2 and/or Column 3 are checked for K0520A and/or K0520B.                   

 

 

 

 

 

 

Item Rationale

Health-related Quality of Life

Nutritional approaches that vary from the normal, such as parenteral/IV or feeding tubes, can diminish an individual’s sense of dignity and self-worth as well as diminish pleasure from eating.

Planning for Care

The proportion of calories received through artificial routes should be monitored with periodic reassessment to ensure adequate nutrition and hydration.

Periodic reassessment is necessary to facilitate transition to increased oral intake as indicated by the resident’s condition.

K0710A, Proportion of Total Calories the Resident Received through Parental or Tube Feeding

Steps for Assessment

Review intake records within the last 7 days to determine actual intake through parenteral or tube feeding routes.

Calculate proportion of total calories received through these routes.

If the resident took no food or fluids by mouth or took just sips of fluid, stop here and

code 3, 51% or more.

If the resident had more substantial oral intake than sips of fluid, consult with the dietician.

Coding Instructions

Select the best response:

25% or less

26% to 50%

51% or more

 

 

Example

Calculation for Proportion of Total Calories from IV or Tube Feeding

Resident H has had a feeding tube since their surgery two weeks ago. They are currently more alert and feeling much better. They have been taking soft solids by mouth, but only in small to medium amounts. Within the last 7 days, they have been receiving tube feedings for nutritional supplementation. The dietitian has totaled their calories per day as follows:

 

 

 

Oral and Tube Feeding Intake

 

	Oral	Tube
Sun.	500	2,000
Mon.	250	2,250
Tues.	250	2,250
Wed.	350	2,250
Thurs.	500	2,000
Fri.	250	2,250
Sat.	350	2,000
Total	2,450	15,000

 

Coding:       K0710A columns 2 and 3 would be coded 3, 51% or more.

Rationale:   Total Oral intake is 2,450 calories

Total Tube intake is 15,000 calories Total calories is 2,450 + 15,000 = 17,450

Calculation of the percentage of total calories by tube feeding: 15,000/17,450 = .859 X 100 = 85.9%

Resident H received 85.9% of their calories by tube feeding, therefore K0710A code 3, 51% or more is correct.

K0710B, Average Fluid Intake per Day by IV or Tube Feeding Steps for Assessment

Review intake records from the last 7 days.

Add up the total amount of fluid received each day by IV and/or tube feedings only.

Divide the week’s total fluid intake by 7 to calculate the average of fluid intake per day.

Divide by 7 even if the resident did not receive IV fluids and/or tube feeding on each of the 7 days.

Coding Instructions

 

Code for the average number of cc per day of fluid the resident received via IV or tube feeding. Record what was actually received by the resident, not what was ordered.

 

 

Code 1: 500 cc/day or less

Code 2: 501 cc/day or more

 

 

Examples

Calculation for Average Daily Fluid Intake

Resident A, a long term care resident, has swallowing difficulties secondary to Huntington’s disease. They are able to take oral fluids by mouth with supervision, but not enough to maintain hydration. They received the following daily fluid totals by supplemental tube feedings (including water, prepared nutritional supplements, juices) within the last 7 days.

 

 

 

IV Fluid Intake

Sun.	1250 cc
Mon.	775 cc
Tues.	925 cc
Wed.	1200 cc
Thurs.	1200 cc
Fri.	500 cc
Sat.	450 cc
Total	6,300 cc

 

Coding:       K0710B columns 2 and 3 would be coded 2, 501cc/day or more.

Rationale:       The total fluid intake by supplemental tube feedings = 6,300 cc 6,300 cc divided by 7 days = 900 cc/day

900 cc is greater than 500 cc, therefore code 2, 501 cc/day or more is correct.

 

 

Resident K has been able to take some fluids orally; however, due to their progressing multiple sclerosis, their dysphagia is not allowing them to remain hydrated enough. Therefore, they received the following fluid amounts within the last 7 days via supplemental tube feedings while in the hospital and after they were admitted to the nursing home.

 

 

 

 

While in the Hospital

 

While in the Nursing Home

 

 

Mon.	400 cc	Fri.	510 cc
Tues.	520 cc	Sat.	520 cc
Wed.	500 cc	Sun.	490 cc
Thurs.	480 cc
Total	1,900 cc	Total	1,520 cc

 

Coding:       K0710B2 would be coded 2, 501 cc/day or more, and K0710B3 would be coded 1, 500 cc/day or less.

Rationale:   The total fluid intake within the last 7 days while Resident K was a resident of the nursing home was 1,520 cc (510 cc + 520 cc + 490 cc = 1,520 cc). Average fluid intake while a resident totaled 507 cc (1,520 cc divided by 3 days). 507 cc is greater than 500 cc, therefore code 2, 501 cc/day or more is correct for K0710B2, While a Resident.

The total fluid intake during the entire 7 days (includes fluid intake while Resident K was in the hospital AND while Resident K was a resident of the nursing home) was 3,420 cc (1,900 cc + 1,520 cc). Average fluid intake during the entire 7 days was 489 cc (3,420 cc divided by 7 days). 489 cc is less than 500 cc, therefore code 1, 500 cc/day or less is correct for K0710B3, During Entire 7 Days.