MDS Item I0400 – Coronary Artery Disease (CAD)

Introduction

Coronary artery disease (CAD) is a leading cause of morbidity and mortality in long-term care residents, impacting their quality of life and care planning. MDS Item I0400 captures the presence of CAD, which includes conditions such as angina, myocardial infarction, and atherosclerotic heart disease (ASHD).

What is MDS Item I0400?

MDS Item I0400 identifies residents with a diagnosis of coronary artery disease (CAD). This condition occurs when the arteries that supply blood to the heart become narrowed or blocked, leading to symptoms like chest pain or even heart attacks. Recognizing and managing CAD is crucial for maintaining cardiovascular health and preventing further complications.

Guidelines for Coding I0400

• Code 1: If the resident has a diagnosis of coronary artery disease, including angina or myocardial infarction.
• Code 0: If the resident does not have CAD.

Instructions:

• Review the resident’s medical records, including physician diagnoses, cardiac tests, and treatment notes, to confirm the presence of CAD during the look-back period.

Example Scenario:

Resident A was diagnosed with coronary artery disease and had a myocardial infarction five years ago. He is currently on medication for CAD management. Code 1 for MDS Item I0400.

Best Practices for Accurate Coding

• Documentation: Ensure CAD is documented in the resident’s medical history, with detailed information about any treatments or medications prescribed.
• Communication: Work closely with cardiologists and healthcare providers to manage symptoms and adjust care as needed.
• Training: Train staff to monitor residents for symptoms of CAD, such as chest pain or shortness of breath.

Conclusion

Accurately coding MDS Item I0400 ensures that residents with coronary artery disease receive the appropriate interventions and care to maintain heart health and prevent further 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 I0400 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.