A resident had a UTI in the hospital but their antibiotics were finished before admitting to the facility. The DC Summary notes “UTI-Resolved”. Should UTI be coded?



Yes, UTI must be coded in I2300 if occurred in the last 30 days.  The RAI Manual (page I-13) notes, “If the diagnosis of UTI was made prior to the resident’s admission, entry, or re-entry into the facility, it is not necessary to obtain or evaluate the evidence-based criteria used to make the diagnosis in the prior setting. A documented physician diagnosis of UTI prior to admission is acceptable.”

Blog by Kristen Walden, MSN, RN, RAC-CT, Proactive Medical Review

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