Understanding and Coding MDS 3.0 Item K0710B2: Average Fluid Intake Per Day IV/Tube – While a Resident

Introduction

Purpose:
Monitoring fluid intake is critical for residents who rely on intravenous (IV) fluids or tube feeding to meet their hydration and nutritional needs. MDS Item K0710B2, Average Fluid Intake Per Day IV/Tube – While a Resident, captures the daily average of fluid intake a resident receives via IV or tube feeding over their stay. Proper coding ensures accurate tracking of hydration levels, which is crucial for maintaining the resident’s health and preventing complications. This article outlines how to correctly code MDS Item K0710B2 according to MDS 3.0 guidelines.

What is MDS Item K0710B2?

Explanation:
MDS Item K0710B2, Average Fluid Intake Per Day IV/Tube – While a Resident, refers to the average daily amount of fluids a resident received through:

• Intravenous (IV) fluids, or
• Tube feeding, calculated over the period they were a resident in the facility.

This item captures the average intake for residents who have been in the facility for less than 7 days or for those who may have had IV/tube feeding during their entire stay. Accurately documenting fluid intake ensures appropriate hydration management and identifies any potential need for intervention.

Guidelines for Coding K0710B2

Coding Instructions:
To accurately code Item K0710B2, follow these steps:

1. Gather Fluid Intake Data During Residency:

   • Review the resident’s medical records to determine the amount of fluid they received via IV or tube feeding for each day of their stay at the facility.
   • Fluids include IV solutions, water flushes, and liquid nutrition provided through the tube.

2. Calculate the Average Daily Fluid Intake:

   • Sum the total amount of fluid intake via IV/tube feeding for the entire period the resident has been in the facility (not to exceed 7 days).
   • Divide the total fluid intake by the number of days the resident has been in the facility to get the average daily intake in milliliters (mL).

3. Code Based on the Average Fluid Intake:

   • Code “1” if the resident’s average daily intake was 500 mL or less per day.
   • Code “2” if the resident’s average daily intake was 501–1,000 mL per day.
   • Code “3” if the resident’s average daily intake was 1,001–1,500 mL per day.
   • Code “4” if the resident’s average daily intake was 1,501 mL or more per day.

4. Enter the Response in Item K0710B2:

   • Select the appropriate code based on the calculated average and enter it in K0710B2.

Example Scenario 1:
A resident received a total of 3,000 mL of fluids via IV and tube feeding over a 3-day stay. The average daily intake is 1,000 mL (3,000 mL ÷ 3 days = 1,000 mL per day). In this case, “2” would be entered in Item K0710B2 to reflect an average intake of 501–1,000 mL per day.

Example Scenario 2:
A resident has been in the facility for 2 days and received a total of 4,500 mL of fluids through tube feeding. The average daily intake is 2,250 mL (4,500 mL ÷ 2 days = 2,250 mL per day). In this case, “4” would be entered in Item K0710B2 to reflect an average intake of 1,501 mL or more per day.

Best Practices for Accurate Coding

Documentation:

• Ensure that fluid intake is accurately recorded daily in the resident’s medical records, with the specific amounts administered via IV or tube feeding.
• If the resident’s fluid intake fluctuates, document the reasons for changes in intake and any adjustments made to their care plan.

Communication:

• Share fluid intake data with the interdisciplinary care team, including nurses, dietitians, and physicians, to ensure the resident’s hydration status is maintained and any necessary interventions are made.
• Discuss any significant changes in fluid intake during care planning meetings to ensure the resident’s hydration needs are met throughout their stay.

Hydration Monitoring:

• Regularly monitor the resident’s fluid intake to identify any patterns or changes that could affect their health. Adjust fluid intake as needed based on clinical assessments and physician recommendations.

Conclusion

Summary:
MDS Item K0710B2 is used to track the average daily fluid intake a resident receives via IV or tube feeding during their stay at the facility. Accurate coding ensures that the resident’s hydration needs are monitored and managed appropriately. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure effective hydration management 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 3-182] for detailed guidelines on coding fluid intake during a resident’s stay.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0710B2: Average Fluid Intake Per Day IV/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.