Understanding and coding MDS Item I0800: Orthostatic Hypotension

MDS Item I0800 – Orthostatic Hypotension

Introduction

Orthostatic hypotension is a common condition in elderly residents, characterized by a sudden drop in blood pressure when standing. MDS Item I0800 captures the presence of orthostatic hypotension, an important condition to monitor as it can increase the risk of falls and other complications.

What is MDS Item I0800?

MDS Item I0800 identifies residents who have been diagnosed with orthostatic hypotension. This condition occurs when blood pressure drops significantly when moving from a sitting or lying position to standing, which can lead to dizziness, fainting, and falls.

Guidelines for Coding I0800

• Code 1: If the resident has a diagnosis of orthostatic hypotension.
• Code 0: If the resident does not have orthostatic hypotension.

Instructions:

• Review the resident’s medical records, including blood pressure readings and physician notes, to confirm the diagnosis of orthostatic hypotension.

Example Scenario:

Resident C has been experiencing dizziness and has been diagnosed with orthostatic hypotension by their physician. Code 1 for MDS Item I0800.

Best Practices for Accurate Coding

• Documentation: Ensure the diagnosis and associated symptoms of orthostatic hypotension are documented in the resident’s medical records.
• Monitoring: Regularly monitor blood pressure when the resident changes positions to assess the condition.
• Training: Train staff to recognize symptoms of orthostatic hypotension and take necessary precautions to prevent falls.

Conclusion

Properly coding MDS Item I0800 allows care teams to identify residents at risk for falls due to orthostatic hypotension, enabling timely interventions to improve safety and care outcomes.

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-10​.

Disclaimer:

Please note that the information provided in this guide for MDS 3.0 Item I0800 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.