Is the respiratory therapy item in the MDS 3.0 (O0400) only include the services provided by a respiratory therapist/respiratory nurse?

Q: Is the respiratory therapy item in the MDS 3.0 (O0400) only include the services provided by a respiratory therapist/respiratory nurse? Can we still code this item if services were provided by only RNs? What kind of documentation is needed to be able to capture this?

A: A respiratory nurse is defined as, “A nurse who received specific training on the administration of respiratory treatments and procedures when permitted by the State Practice Act. This training may have been provided at a hospital or nursing facility as part of work experience or as part of an academic program. Nurses do not necessarily learn these procedures as part of their formal nurse training programs.” The services of the RN must be by a nurse who has received specified training.

5 Comments

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  2. Jeff

    I have a couple of questions regarding this:

    1) What proof do we need to have that shows that an RN had been trained?

    2) The minutes, what exactly does the nurse have to document regarding minutes?
    Do they have to document start time, end time? Or just total minutes?

  3. Kristine Wikner

    Can we be trained for this working as an RN in Iowa?? My DON said respiratory therapy does not increase the RUG. ?? And how do you show proof of this traing- thinking of state there. More importantly, does it increase the RUG if I would go to all this work of trying to get trained and implement it in our facility. I am an RN MDS coordinator and medicare nurse.. /thanks

  4. Here are the qualifiers for Special Care High, which can include Respiratory Therapy:
    B0100, ADLs Comatose and completely ADL dependent or ADLs did not occur
    I2100 Septicemia
    I2900, N0350A,B Diabetes with both of the following: Insulin injections (N0350A) for all 7 days Insulin order changes on 2 or more days (N0350B)
    I5100, ADL Score Quadriplegia with ADL score >= 5
    I6200, J1100C Chronic obstructive pulmonary disease and shortness of breath when lying flat
    J1550A, others Fever and one of the following; I2000 Pneumonia J1550B Vomiting K0300 Weight loss (1 or 2) K0500B Feeding tube*
    K0500A Parenteral/IV feedings
    O0400D2 Respiratory therapy for all 7 days

    *Tube feeding classification requirements:
    K0700A is 51% or more of total calories OR
    K0700A is 26% to 50% of total calories and K0700B is 501 cc or more per day fluid enteral intake in the last 7 days.

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