Q:
When a resident who has a feeding tube for nutrition is receiving speech therapy and has orders for a pureed diet/thickened liquid trials at lunch during therapy sessions, should this be coded on the MDS as a mechanically altered diet in section K0510?
A:
Mechanically altered diet should be coded on the MDS, if the pureed diet/thickened liquid was received during the 7-day assessment period.
The RAI manual indicates the medical record should be reviewed to determine if any of the nutritional approaches listed in K0510 were performed during the seven-day look-back period. In addition to a physician order for the diet consistency provided, the speech therapy documentation should support this ordered diet consistency was received by the resident during the therapy sessions in the assessment look back period. The documentation should also indicate how the diet was tolerated along with any noted swallowing issues coded in section K0100, if applicable.
Christine Twombly, RN-BC, RAC-MT, RAC-MTA, HCRM, CHC
Clinical Consultant
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