severe malnutrition

kerryseekircherkerryseekircher
in CDI Talk Archive
If a patient meets Aspen criteria for severe malnutrition, but is not receiving tube feeds/tpn, etc.., will you still query for this diagnosis?
Perhaps I'm being too conservative, but I generally expect to see consideration of these types of resources in conjunction with this diagnosis.
The problem I am seeing is that sometimes patients meet Aspen criteria, but the patient may only be receiving ensure and a follow up with nutrition.

Any feedback appreciated.
Thanks,
Kerry


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Comments

  • angelisa.romanelloangelisa.romanello
    edited April 2016
    If the severe malnutrition or any malnutrition is present, we like to capture that information for an accurate picture of the patient. Even if there is not a treatment at this particular time, it should be measured.

    One other reason, we like to document the level of malnutrition is to follow up and make sure there is no skin breakdown or alterations.

    Just my thoughts.
    Thank you

    Lisa Romanello, RN,BSN,FNS,CCDS
    Manager, Clinical Documentation Improvement Specialist
    Quality Department
    CJW Chippenham Campus
    AHIMA Approved ICD-10 CM/PCS Trainer
    Angelisa.Romanello@hcahealthcare.com
    804-228-6527

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited April 2016
    Absolutely! This dx does not necessitate tube feeds and/or TPN. Our nutritionists routinely make this dx on patients that are not on tube feeds/TPN. In fact I would be willing to bet we see this more often in patients that are NOT on tube feeds or TPN because this is a chronic condition most of the time so they come in with it.

    I think we definitely want to see resource utilization but the designation of 'severe' also indicated severity of illness. Though they may not be receiving tube feeds or TPN, patients with severe PCM are medically fragile; prone to infection, poor wound healing, at risk for pressure ulcers, etc. The increase in resources is more than nutrition supplementation.

    My two cents...


    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404

  • kerryseekircherkerryseekircher
    edited April 2016
    I appreciate your two cents! I had a feeling that this may be the case. Our coding staff is very concerned about RAC denials/audits. Any audits I have seen in the past are referencing lack of aspen criteria-so I'm thinking that with appropriate documentation we should be okay.

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