Q: I am having a hard time understanding why we are coding for pain when nurses are managing pain by administering prophylactics PRN (“as needed”) in anticipation of pain. In this instance, does the MDS nurse have to code pain daily?
Diane: Coding pain frequency under the MDS 2.0 is based on how often the resident complains or shows evidence of pain. Coding for frequency is not affected by the way pain medications are administered, e.g., as a prophylactic.
It’s important to remember to ask all residents about their pain. With the new pain management guidance and investigative protocols under F309, which CMS is expected to release at any moment, surveyors will soon be investigating whether nursing facilities are assessing pain accurately in all residents. We’ll post more information about F309 as it becomes available at MDSCentral.