Understanding and Coding MDS 3.0 Item K0710B3: Average Fluid Intake Per Day IV/Tube – 7 Days

Introduction

Purpose:
Accurate documentation of a resident’s fluid intake is crucial for ensuring proper hydration and nutrition, particularly for those who rely on IV fluids or feeding tubes. MDS Item K0710B3, Average Fluid Intake Per Day IV/Tube – 7 Days, captures the average amount of fluid the resident received via IV or tube feeding over a 7-day period. Proper coding of this item ensures that the resident’s hydration status is monitored and managed effectively. This article outlines how to code MDS Item K0710B3 based on MDS 3.0 guidelines.

What is MDS Item K0710B3?

Explanation:
MDS Item K0710B3, Average Fluid Intake Per Day IV/Tube – 7 Days, refers to the average daily amount of fluid intake the resident received through either:

• Intravenous (IV) fluids, or
• Tube feeding over a consecutive 7-day period.

This item is critical for residents who cannot take fluids orally and rely on alternate methods to meet their hydration needs. Documenting this helps ensure that the resident’s intake meets their fluid requirements and any necessary adjustments are made to their care plan.

Guidelines for Coding K0710B3

Coding Instructions:
To correctly code Item K0710B3, follow these steps:

1. Collect Fluid Intake Data for the Last 7 Days:

   • Review the resident’s medical records to determine the amount of fluid they received through IV or tube feeding over the last 7 days.
   • Fluids may include IV solutions, water flushes, and nutrition delivered via tube feeding.

2. Calculate the Average Daily Fluid Intake:

   • Sum the total amount of fluid intake from IV or tube feeding for the entire 7-day period.
   • Divide the total by 7 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 K0710B3:

   • Based on the calculated average, select the appropriate code and enter it in K0710B3.

Example Scenario 1:
A resident receives a total of 3,500 mL of fluids through a feeding tube over a 7-day period. The average daily intake is 500 mL (3,500 mL ÷ 7 days = 500 mL per day). In this case, “1” would be entered in Item K0710B3 to reflect an average intake of 500 mL or less per day.

Example Scenario 2:
A resident receives 9,800 mL of fluids through IV over a 7-day period. The average daily intake is 1,400 mL (9,800 mL ÷ 7 days = 1,400 mL per day). In this case, “3” would be entered in Item K0710B3 to reflect an average intake of 1,001–1,500 mL per day.

Best Practices for Accurate Coding

Documentation:

• Ensure that fluid intake records are accurately maintained, including the amount and type of fluids administered through IV or tube feeding. Regular monitoring ensures precise calculation of daily averages.
• Document any changes in fluid intake or the resident’s hydration status in their care plan to ensure timely interventions if needed.

Communication:

• Communicate the resident’s fluid intake levels to the interdisciplinary care team, including dietitians, nurses, and physicians, to ensure that hydration needs are met and the care plan is adjusted as necessary.
• Discuss any significant changes in fluid intake during care planning meetings to ensure proper follow-up and monitoring.

Fluid Monitoring:

• Regularly reassess the resident’s hydration status, especially if they are at risk of dehydration or overhydration, to ensure their fluid intake remains appropriate for their needs.
• Adjust fluid intake as required, based on clinical assessments and physician recommendations.

Conclusion

Summary:
MDS Item K0710B3 captures the average daily fluid intake received through IV or tube feeding over a 7-day period. Accurate coding of this item ensures that the resident’s hydration needs are being monitored and met appropriately. By following the guidelines and best practices outlined in this article, healthcare professionals can ensure that fluid intake for residents in long-term care settings is managed effectively, promoting optimal health and well-being.

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 calculating and coding fluid intake for residents.

Disclaimer

Please note that the information provided in this guide for MDS 3.0 Item K0710B3: Average Fluid Intake Per Day IV/Tube – 7 Days 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.