Q&A: If a resident is on a fluid restriction due to hyponatremia, would this be coded as a therapeutic diet at K0510D?

Jane Belt, MS, RN, RAC-MT, QCP

Question: If a resident is on a fluid restriction due to hyponatremia, would this be coded as a therapeutic diet at K0510D?

Answer: The fact that the resident needs less fluids would not mean that the resident needs a therapeutic diet. 

The box definition in the RAI User’s Manual states:

THERAPEUTIC DIET
A therapeutic diet is a diet intervention ordered by a health care practitioner as part of the treatment for a disease or clinical condition manifesting an altered nutritional status, to eliminate, decrease, or increase certain substances in the diet (e.g. sodium, potassium) (ADA, 2011).

Under the Coding Tips for K0510D:
Therapeutic diets are not defined by the content of what is provided or when it is served, but why the diet is required. Therapeutic diets provide the corresponding treatment that addresses a particular disease or clinical condition which is manifesting an altered nutritional status by providing the specific nutritional requirements to remedy the alteration. 


The fluid restriction would not be addressing specific nutritional requirements. That said, you may also want to double-check with your state RAI coordinator.


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