Ask Diane: How should I code Section K of the MDS?

By: Diane Brown July 24th, 2009

Q: If a resident with dentures is able to tolerate a regular diet, how should I code Section K of the MDS for chewing/swallowing? Also, are vitamins, minerals, and herbal supplements counted as dietary supplements between meals?

Diane: If the resident had or continues to have a chewing or swallowing problem during his or her admission, you must code it in Section K of the MDS. Even if the clinical team has already intervened and resolved the issue, the problem must be coded on the MDS.

If vitamins are in pill form, they are considered medications. If vitamins are included in food supplements or a nutritional drink, such as Ensure, they are considered dietary supplements. Minerals and herbal supplements are not regulated by the U.S. Food and Drug Administration and are considered dietary supplements regardless of what form they are taken.

Comments(9) Ask the Experts, MDS 2.0, MDS 3.0 Items

Comments

By Carol Tyrol on July 30th, 2009 at 10:53 am

Are you saying that calcium, zinc, and mag. oxide are not regulated by the FDA and are not considered medications?

By Mindy Krumdieck on August 4th, 2009 at 10:05 am

How would you code a physcians order for a probiotic Culturelle Med or Dietary Supplement?

By MacKenzie Kimball on August 5th, 2009 at 3:40 pm

Mindy, you would code Culturelle as a dietary supplement.

Carol, the answer to your question is rather lengthy, so I will be contacting you directly.

By Kay Morris on October 8th, 2009 at 5:30 pm

Diane,

Regarding coding the weight loss/gain for section K: If the closest weight to 30 days previous is less than 30 days (say 27 days) and the next weight prior to that is greater than 30 days (say 45 days) which weight would you use to code? Would you code not known because there is no weight exactly 30 days prior? Does the weight have to be 30 days or more, but not less than 30 days? Would greatly appreciate your advice.

By Susanna Banks on December 16th, 2009 at 5:36 pm

I have the same question as Kay above. The instructions for section K say use the closest weight if you have it, but the operative word for my facility is “have”. Weekly weights are not as reliable and therefore not available at the writing of the MDS, or they may appear in the weight book after the MDS is completed. Someone coming in afterwards may see a weight you didn’t. Computer printouts are usually just monthly weights. Please advise. Thank you!

By Tina Wheatley on June 15th, 2010 at 2:10 pm

I have an elder with bilateral AKA. When it comes to height on the MDS, do I code what her height is now or what her original height would have been?

By Sue Durkin on September 8th, 2010 at 8:06 pm

If a patient is admitted w/2+ edema and wt of 120 and is on lasix 40 mg. After 5 days looses 7# and the edema is resolved, how would that be coded

By Shannon Johnson on December 29th, 2010 at 8:43 pm

If a resident is on a mechanically altered diet because he has chewing problems, but he does not have problems any longer because he is on a mechnically altered diet, you do not code that he/she has chewing problems, correct? You do however code that they are on the mechnically altered diet.

By Shannon Johnson on December 29th, 2010 at 8:43 pm

correct to above statement?