Questions and Answers Regarding Using the New Nutrition Education Codes

Questions and Answers regarding using the new Nutrition Education Codes

The nutrition education codes were revised to be more encompassing and allow more generalized coding yet more flexibility in choosing education topics based on the individual and/or family’s nutritional needs.

There are several two-letter nutrition codes that can be assigned to everyone in the household. They are DG (Dietary Guidelines), MP (Menu Planning), FP (Food Preparation), OH (Oral Health), PA (Physical Activity), and MR (Missed or refused). If the nutrition education topic does not fall under a household code, e.g., DG, MP, FP, OH or PA, it should be coded to the participant’s category determined by whether they are high risk or not. A “G” after the category letter indicates a general nutrition education topic; an “H” after the category letter indicates a high-risk nutrition education topic. Each program category (P, B, N, I, C) has “G” for general and “H” for high-risk. The determination of what is considered general vs. high-risk is dependent upon the topic being addressed.

Example 1: Nutrition education on maternal weight loss and weight gain during pregnancy is provided to a prenatal who is high risk (RF #X1 (Low Maternal Weight Gain). It would be coded as PH (Prenatal Nutrition - High Risk). You would use the “PH” for topics such as nausea/constipation/heartburn and adolescent pregnancy.

Example 2: Nutrition code “PG” is a general topic for Prenatals and could include topics such as advantages of breastfeeding, weight gain during pregnancy, and daily nutrient needs. Some of the household topics such as vitamin C, iron, calcium, vitamin A and others could also be included.

The code AR (all required) covers the required topics for the initial “00” nutrition education contact.

A new Breastfeeding Peer Counseling “BP” code was created to help peer counselors document how many contacts they provide. This code can only be used by the 49 Breastfeeding Peer Counseling (BFPC) agencies that were awarded the Breastfeeding Peer Counseling grant for FFY 2007 and has been blocked in HANDS for non-BFPC agencies. Peer counselor contacts do not count as one of the two required nutrition education contacts. Therefore the “BP” code must be used to document peer counselor contacts. One exception is when the peer counselor teaches a breastfeeding class using a lesson plan approved by the Breastfeeding Coordinator. In this instance they should code BG (Breastfeeding General), since the contact counts as one of the two required nutrition contacts. For “Mother Support Groups” or other informal sessions, provided by peer counselors, where an approved lesson plan is not used, the BP (Breastfeeding Peer Counseling) code should be used - this does not count as one of the two required nutrition contacts.

When a nutrition education code & contact date are entered into HANDS using any DCN of the family, the system will populate the code to all applicable participants who’s certification period falls within the time of the contact, e.g., an infant turns 1 year and is certified in October as a child and has a sibling who was certified in August, the general “Children” nutrition education code (CG) or “household” codes would automatically populate to both children. The nutrition topic applies to both children and the information should apply to all children in that family.

1. How should nutrition education for substance abuse be coded?

A: It should be coded to the applicable participant category (PG, PH, BG, BH, NG, NH, CG, CH, IG, IH) dependant upon whether the participant is high risk or not. When it is offered as a class or as individual counseling it is not appropriate to code “AR” for “substance abuse” topic since “AR’ covers several topics during the initial nutrition education contact.

2. Our agency provides one-on-one family counseling and does not offer classes. How should we use the new individual topic(s) to address the needs of the family?

A. The nutrition education codes used must reflect the topic as it relates to the nutritional needs of each participant in the family. Example: When counseling a breastfeeding woman with an infant and a 3-year old child, you discuss the topics “weaning & homemade baby food”, “IG” should be keyed in HANDS. The system will only capture this code in the infant’s record and will not populate this topic to the mother’s and the child’s records since the topic is not appropriate for a breastfeeding mother or a 3-year old child. If this family is on a bi- monthly food issuance cycle, in order to comply with the “2 minimum nutrition education contacts within each 6-month period” requirement, a child-related topic and a breastfeeding-related topic need to be provided for this family at the same visit or next check pick-up appointment. However, if the topic “iron deficiency anemia” is discussed with the same family, codes “BG”, “IH” and “CG” (or “CH” if the child is high-risk) should be entered using any DCN of this family, the system will then populate “BG” to the mother’s record, “IH” to the infant’s record and “CG” (or “CH”) to the child’s record.

WOM Policy ER 2.06100 states, “The title of the topic given must be documented in each participant’s file.” It is important to know what educational information is provided to the participant(s) so the local agency nutritionist or CPA can follow-up with the participant ‘s needs and understanding during future visits. It is not acceptable to use old education codes to document what educational topic was given to participants.