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MDS Item O0110: Keys to Coding Under PDPM

By Caralyn Davis, Staff Writer - January 08, 2020

Ten subitems in MDS item O0100 (Special Treatments, Procedures, and Programs) can affect from one to three of the case-mix-adjusted payment components in the Patient-Driven Payment Model (PDPM): speech-language pathology (SLP), nontherapy ancillaries (NTA), and/or nursing. The following chart shows the potential impacts:

 

O0100 Item

Potential PDPM Impact

O0100A2 (Chemotherapy While a Resident)

Nursing Clinically Complex

O0100B2 (Radiation While a Resident)

NTA (1 point), Nursing Special Care Low, Nursing Clinically Complex

O0100C2 (Oxygen Therapy While a Resident)

· Must be in combination with I6300 (Respiratory Failure) to qualify for Nursing Special Care Low

Nursing Special Care Low, Nursing Clinically Complex

O0100D2 (Suctioning While a Resident)

NTA (1 point)

O0100E2 (Tracheostomy Care While a Resident)

SLP, NTA (1 point), Nursing Extensive Services, Nursing Clinically Complex

O0100F2 (Invasive Mechanical Ventilator (ventilator or respirator) While a Resident)

SLP, NTA (4 points), Nursing Extensive Services, Nursing Clinically Complex

O0100H2 (IV Medications While a Resident)

NTA (5 points), Nursing Clinically Complex

O0100I2 (Transfusions While a Resident)

NTA (2 points), Nursing Clinically Complex

O0100J2 (Dialysis While a Resident)

Nursing Special Care Low, Nursing Clinically Complex

O0100M2 (Isolation or Quarantine for Active Infectious Disease (does not include standard body/fluid precautions) While a Resident)

NTA (1 point), Nursing Extensive Services, Nursing Clinically Complex


Note: When more than one nursing category is listed, the resident may be classified into the lower category depending on other MDS data, e.g., the resident’s nursing function score.