Q:
We have a resident who receives Haldol decanoate injections every 3 weeks. How is this coded in section N of the MDS?
A:
Haldol decanoate is a long-acting antipsychotic medication and the MDS 3.0 RAI User Manual provide the following guidance related to coding high risk medications in section N0415:
Count long-acting medications, such as fluphenazine decanoate or haloperidol decanoate, that are given every few weeks or monthly only if they are given during the 7-day look-back period
Based on this guidance antipsychotic medications in section N0415A should only be checked if the injection was administered during the assessment look back period. The assessment period for Section N0450, Antipsychotic Medication Review is different and should be coded if the resident received an antipsychotic medication since admission entry/reentry or since the prior OBRA assessment, whichever is most recent. This section should be coded yes, antipsychotic received on a routine basis, if the injection was received at any time during the assessment period, which would lead to the completion of the questions related to the gradual dose reduction being completed.
Christine Twombly, RN-BC, RAC-MT, RAC-MTA, HCRM, CHC
Clinical Consultant
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