Understanding and Coding MDS 3.0 Item K0710A2: Proportion of Calories Parenteral/Tube Feed – While a Resident

Introduction

Purpose:
MDS Item K0710A2, Proportion of Calories Parenteral/Tube Feed – While a Resident, helps track the percentage of a resident's total caloric intake provided through parenteral nutrition or tube feeding over their time at the facility. This item is essential for monitoring nutritional intake for residents who cannot consume adequate calories orally. Accurate coding of this item ensures proper nutritional care and helps the care team make necessary adjustments. This article provides guidance on how to properly code MDS Item K0710A2 based on MDS 3.0 standards.

What is MDS Item K0710A2?

Explanation:
MDS Item K0710A2, Proportion of Calories Parenteral/Tube Feed – While a Resident, records the percentage of total calories that the resident received from either:

• Parenteral nutrition (nutrition provided intravenously), or
• Tube feeding during their stay in the facility.

This item is vital for residents who rely on alternative feeding methods to meet their caloric needs, especially if they have been in the facility for less than 7 days or if their feeding method changed during their stay.

Guidelines for Coding K0710A2

Coding Instructions:
To correctly code Item K0710A2, follow these steps:

1. Review Nutritional Intake Records:

   • Collect data from the resident's medical records, focusing on the number of calories they received through parenteral nutrition or tube feeding during their time at the facility.

2. Calculate the Proportion of Calories from Parenteral/Tube Feeding:

   • Determine the total calories the resident consumed during their stay, including both oral and parenteral/tube-fed calories.
   • Divide the calories from parenteral or tube feeding by the total caloric intake to calculate the percentage of calories from these non-oral feeding methods.

3. Code Based on the Proportion of Calories:

   • Code “1” if the resident received 25% or less of their total calories from parenteral nutrition or tube feeding.
   • Code “2” if the resident received 26% to 50% of their total calories from parenteral nutrition or tube feeding.
   • Code “3” if the resident received 51% to 75% of their total calories from parenteral nutrition or tube feeding.
   • Code “4” if the resident received 76% or more of their total calories from parenteral nutrition or tube feeding.

4. Enter the Response in Item K0710A2:

   • Based on the percentage calculated, select the appropriate code and enter it in K0710A2.

Example Scenario 1:
A resident received 2,000 calories from tube feeding and an additional 1,000 calories orally during their 3-day stay. The total caloric intake was 3,000 calories, with 67% (2,000 ÷ 3,000) coming from tube feeding. In this case, “3” would be entered in Item K0710A2 to reflect that 51% to 75% of the resident’s calories came from parenteral/tube feeding.

Example Scenario 2:
A resident received 800 calories from parenteral nutrition and 3,200 calories orally during their 5-day stay. The total caloric intake was 4,000 calories, with 20% (800 ÷ 4,000) from parenteral nutrition. In this case, “1” would be entered in Item K0710A2 to reflect that 25% or less of the calories came from parenteral/tube feeding.

Best Practices for Accurate Coding

Documentation:

• Keep detailed records of the resident’s caloric intake from both parenteral nutrition or tube feeding and oral intake during their stay in the facility.
• Document any changes in feeding methods and their impact on the resident’s nutritional status.

Communication:

• Share the resident’s nutritional intake with the interdisciplinary care team, including dietitians, nurses, and physicians, to ensure that the resident’s caloric and nutritional needs are met.
• Discuss any changes in the resident’s feeding plan during care meetings to ensure that proper interventions are implemented and the care plan is up to date.

Nutritional Monitoring:

• Regularly reassess the resident’s nutritional status to ensure that they are receiving the proper amount of calories and nutrients to maintain health and prevent malnutrition.
• Adjust the care plan as needed based on changes in the resident’s feeding method or caloric intake.

Conclusion

Summary:
MDS Item K0710A2 is essential for tracking the percentage of calories a resident receives through parenteral nutrition or tube feeding during their stay at the facility. Proper coding ensures that the resident’s caloric intake is accurately monitored and helps ensure their nutritional needs are met. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure effective nutritional care for residents in long-term care settings.

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 3-180] for detailed guidelines on coding caloric intake from parenteral nutrition and tube feeding.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0710A2: Proportion of Calories Parenteral/Tube Feed – 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.