Understanding and Coding MDS 3.0 Item K0520B3: Nutritional Approaches - Feeding Tube While a Resident

Understanding and Coding MDS 3.0 Item K0520B3: Nutritional Approaches – Feeding Tube While a Resident

Introduction

Purpose:
MDS Item K0520B3, Nutritional Approaches – Feeding Tube While a Resident, documents whether a resident was using a feeding tube during their stay in the facility. Feeding tubes provide essential nutrition for residents who cannot consume food orally due to medical conditions such as dysphagia, gastrointestinal disorders, or severe malnutrition. Proper coding of this item ensures accurate documentation of the resident’s nutritional needs and supports proper care planning. This article explains how to correctly code MDS Item K0520B3 based on MDS 3.0 guidelines.

What is MDS Item K0520B3?

Explanation:
MDS Item K0520B3 refers to residents who were using a feeding tube at any point during their stay in the facility. A feeding tube allows direct delivery of nutrition, fluids, and medication to residents who cannot safely eat or swallow. Types of feeding tubes include:

• Nasogastric (NG) tube,
• Gastrostomy (G-tube),
• Jejunostomy (J-tube).

This item ensures that the use of a feeding tube is documented to help track the resident’s ongoing nutritional interventions.

Guidelines for Coding K0520B3

Coding Instructions:
To accurately code Item K0520B3, follow these steps:

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

   • Check the resident’s medical records and care plan to confirm whether they were using a feeding tube at any time during their stay in the facility.

2. Confirm Feeding Tube Use During the Resident’s Stay:

   • Ensure that the feeding tube was used to provide nutrition, fluids, or medication as part of the resident’s care while they were in the facility.

3. Code Based on Feeding Tube Use:

   • Code “1” for Feeding Tube While a Resident if the resident used a feeding tube during any part of their stay.
   • If the resident did not require a feeding tube, leave this item unmarked and code the appropriate nutritional approach.

4. Enter the Response in Item K0520B3:

   • If the resident was on a feeding tube at any point during their stay, enter “1” in K0520B3.

Example Scenario 1:
A resident with swallowing difficulties due to a stroke was placed on a nasogastric (NG) tube for nutrition during their stay in the facility. In this case, “1” would be entered in Item K0520B3 to document that a feeding tube was used.

Example Scenario 2:
A resident undergoing long-term care for gastrointestinal issues was using a gastrostomy (G-tube) to receive nutrition. In this case, “1” would be entered in K0520B3 to indicate feeding tube use.

Best Practices for Accurate Coding

Documentation:

• Ensure that the resident’s care plan clearly documents the need for a feeding tube, the type of tube used, and the nutritional regimen followed.
• Note any changes to the resident’s feeding tube care, including adjustments to the feeding schedule or feeding method.

Communication:

• Ensure that all members of the interdisciplinary care team, including nurses, dietitians, and speech-language pathologists, are informed about the resident’s feeding tube use.
• Educate caregivers and family members about the importance of feeding tube care and monitoring for complications, such as infection or blockage.

Monitoring and Follow-Up:

• Regularly monitor the resident’s condition to ensure that the feeding tube is functioning properly and that their nutritional needs are being met.
• Schedule routine follow-ups with the healthcare provider or dietitian to assess the resident’s progress and adjust the feeding tube regimen if needed.

Conclusion

Summary:
MDS Item K0520B3 is used to document whether a resident used a feeding tube during their stay in the facility. Proper coding ensures that the resident’s nutritional needs, including the use of enteral nutrition, are accurately documented for care planning. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure appropriate documentation and care for residents requiring feeding tubes.

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 3-184] for detailed guidelines on coding feeding tube use during residency.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0520B3: Nutritional Approaches – Feeding Tube While a Resident 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.