Posts tagged ‘m2400’

October 12, 2012

Does N/A in one place mean N/A in all?

Question: If a M2250 question is answered N/A on the SOC or ROC, would M2400 on the transfer or DCO automatically be N/A as well?

For example:  M2250 (E) pain was answered N/A on the SOC because no pain was identified. Then sometime during the episode the patient fell and now has pain in the Rt knee r/t the fall. The patient is placed on a pain medication for the acute pain. The nurse identifies the need for pain interventions to monitor and mitigate the pain.  The nurse uses a standardized pain assessment tool to rate the pain, writes a verbal order to add pain interventions to the POC, and implements the interventions.  At the discharge OASIS, would M2400 (D) be answered N/A because no other OASIS was performed since the SOC and on the SOC the POC synopsis (E) was N/A OR since the nurse addressed the pain by assessing the patient’s pain with the standardized tool, wrote the VO to include the interventions in the POC and implemented them, could she answer #1 on M2400 ?

Lisa says: Intermittent verbal orders count as well, so if you get an order for assessment and intervention sometime in the episode and the interventions are completed as you described in your scenario, then the answer is ‘yes’ on the discharge.

Formal assessment does mean the standardized and/or validated tools contained in those specific M items you mentioned. The trick is that if the last assessment done was the recert, those M items are not part of the recert. However, N/A cannot apply if no formal assessments were done, so when discharging and the last OASIS was a recert the answer has to be either yes or no.

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August 23, 2010

M1240 … a pain to get right?

Pain is such a subjective subject, and I’ve heard from many clinicians who wonder how to answer M1240 correctly … does it refer only to severe pain? When does pain qualify? So let’s look at the question, then at ways to assess.

M1240: Has the patient had a formal pain assessment using a standardized pain assessment tool (appropriate to the patient’s ability to communicate the severity of pain)?
0: No standardized assessment conducted
1: Yes, and it does not indicate severe pain
2: Yes, and it indicates severe pain

The OASIS Guidance Manual tells us that this item’s intent is to see if a standardized assessment was conducted, and what the level of pain was, if, and only if, the assessment was conducted.

The item’s intent deals with the assessment, and CMS has stated that clinicians should assess for “any and all pain the patient experiences.” (April 2010)

When dealing with M1240, watch M2250 (Plan of Care Synopsis) and M2400 (Intervention Synopsis).

M2250 is where it would be noted if the doctor ordered interventions and monitoring for the pain. Only mark NA if the patient is not experiencing pain. (That’s NO PAIN AT ALL.)