Q:
We have a resident who has a progress note documenting that resident requested HOB to be elevated because when lying down flat he can’t “catch his breath.” He doesn’t have COPD but he does have pulmonary fibrosis which is listed on his hospital H&P and receives an inhaler to help with symptom management. Is it okay to mark at I6200 on his 5-day PPS assessment?
A:
Yes, pulmonary fibrosis is considered a chronic restrictive disease and can be marked at I6200. Item I6200 is not only intended for COPD but for a diverse range of chronic restrictive and obstructive lung diseases. Your PDPM nursing component will be special care high by coding I6200 & J1100C (SOB while lying flat). In addition, if you add the ICD-10 code for pulmonary fibrosis at I1800 on the MDS, you will capture 3 NTA points (2 points for the chronic lung disease and 1 point for pulmonary fibrosis).
This information can be reviewed from the RAI 3.0 User’s Manual, Version 1.18.11
- I6200, Asthma, COPD, & Chronic Lung Disease, Page I-7 – I-12
- I1800, Other additional Active Diagnosis, Page I-7 – I-12
- J1100, Shortness of Breath, Page J-24 & J-25
- PDPM Payment Component, NTA, Page 6-29 – 6-32
- PDPM Payment Component, Nursing Category: Special Care High, Page 6-36 – 6-38
Jessica Miller, RN, RAC-CT
MDS Consultant
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