by Richard D. Pinson, MD, FACP, CCS
Q: We have been told we can select ASPEN malnutrition parameters across the clinical contexts for severe malnutrition such as <75% energy requirement for >1 month from the chronic context and moderate muscle and fat loss from the acute context. Is this a proper application of the ASPEN criteria?
A: One must stay within the specific clinical context one is using (acute, chronic, socio-environmental), not picking criteria from different contexts. There’s also a problem with caloric intake for severe malnutrition in the chronic context you mentioned: it’s the same as non-severe and out of sync with the acute and socio-environmental contexts where it’s <50%. We advise using <50% in all three for consistency and compliance concerns.
The Pinson & Tang CDI Pocket Guide provides specific standardized query templates for the most common medical conditions as well as instruction on how to modify the template to fit the particular circumstances of the case in question.
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About the Author
Dr. Richard Pinson, MD, FACP, CCS
Dr. Richard Pinson is a physician, educator, administrator, and healthcare consultant. He practiced Internal Medicine and Emergency Medicine in Tennessee for over 20 years having board certification in both. Dr. Pinson is a Fellow of the American College of Physicians and former Assistant Professor of Clinical Medicine at Vanderbilt, and has assisted hospitals as a physician consultant for the past ten years. Dr. Pinson’s personal understanding of the mindset of both doctors and managers allows him a unique vantage point from which to promote cooperation between physicians, hospital staff, and administrators toward achieving beneficial and practical changes.