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Q: I count tuberculosis (TB) skin tests as injections in MDS item O3, injections. Should I also count this as a medication in item O1?

Julia's PPS Chat, May 12, 2004

Welcome back to another edition of PPS chat!

Once again, we're going to talk about counting. This seems like such as easy subject-however, when counting for the MDS, you may find things can become a little more difficult.

Read on to learn how to count skin tests.

Q: I count tuberculosis (TB) skin tests as injections in MDS item O3, injections. Should I also count this as a medication in item O1?

A: You are correct to count TB skin tests as injections.

The Resident Assessment Instrument (RAI) User's Manual on pp. 3-178 and 3-179 instructs you to count "the number of days during the past seven days that the resident received any type of medication, antigen, [or] vaccine by subcutaneous, intramuscular, or intradermal injection."

The manual continues, "Although antigens and vaccines are considered 'biologicals'-and not medications per se-it is important to track when they are given to monitor for localized or systemic reactions."

CMS has further clarified this area in the April 2004 revisions to the RAI User's Manual. This clarification states that you should code antigens and vaccines in item O1, medications. Therefore, you will be coding this skin test in both O1 and O3.

Always remember that both of these items ask for a seven-day lookback period and to code them using different guidelines. Item O1, number of medications, asks for the number of different medications a resident has received, but O3, injections, asks for the number of days injections were administered.

Hopefully, now you'll understand more about counting and coding skin tests. Our next PPS Chat will talk about the differences between electronic and hand-written copies of the MDS.

Until then