Harmony Healthcare Blog

MDS Coding Revision Effective 10.1.17: Urinary Tract Infection (UTI) Without an Indwelling Catheter

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Thu, Nov 09, 2017

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Edited by Kris Mastrangelo

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Smiling nurse and happy elderly lady, horizontal.jpegThe new MDS guidelines for coding UTI’s without a in indwelling catheter are causing significant confusion in the industry. The criterion is drastically different than the past definition and many nurses require time to assimilate the change. The refinement is a result of studies depicting the probability of urinary tract infections when symptoms are non-existent combined with the evidenced based value of a urine culture for microbiologic confirmation.

The below synopsis is intended to provide clarity on the subject matter:

The change in the coding for Section I (Active Diagnoses):  I2300 (Urinary Tract Infection: UTI) is effective Oct. 1, 2017.

The UTI is coded on the MDS only if both the following criteria are met in the last 30 days:

  1. It is determined that the resident has a UTI using evidence-based criteria such as McGeer, NHSN, or Loeb in the last 30 days,

and

  1.  A physician-documented UTI diagnosis in the last 30 days. 

The RAI User’s Manual further states that providers must use a tool that is linked to their Infection Prevention and Control Program.

McGeer evidenced-based UTI Criteria for patients without an indwelling catheter: 

The MDS coding of UTI is supported if one of the three following criteria are present in combination with positive laboratory findings of at least 105 cfu/ml of no more than 2 microorganisms per voided specimen or at least 102 cfu/ml of any number of organisms in a specimen collected via in and out catheterization. 

One of the 3 below with positive lab findings: 

  1. Acute dysuria or acute pain swelling or tenderness of the testes, epididymis or prostate, alone
or

  1. Fever (temperature of 100°F (38°C) or 2.4 degrees above the patient’s baseline temperature) and at least one new or worsening of the following: 
    • •  Urgency
      •  Suprapubic Pain
      •  Frequency
      •  Gross Hematuria
      •  Back or Flank Pain
      •  Urinary Incontinence

or

  1. In the absence of a fever, two or more of the above symptoms identified in number 

Please note that there is a separate McGeers criteria for patients with an indwelling catheter. 

Harmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have.  You can contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 


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Tags: Coding UTI

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