Identifying Malnutrition: Dietitian’s Role in Coding and Reimbursement Author(s): K. Fedder, W. Duddey; University of Kentucky Healthcare Learning Outcome: Learner will be able to describe the impact of appropriately coding and documenting malnutrition on hospital reimbursement values. It is estimated that 20-50% of hospitalized patients are malnourished on admission. Malnutrition in the hospital setting increases length of stay, development of pressure ulcers, infection rates, and use of resources. Regis- tered Dietitians are now preforming Nutrition Focused Physical Exams (NFPE) to screen for malnutrition. Failing to appropriately capture a malnutrition diagnosis can leave potential reimbursement unclaimed. The purpose of this study was to examine effects of dietitian led NFPEs, along with updates made to the electronic medical record to reflect the NFPE, on the rates of malnu- trition diagnosing and hospital reimbursement within the University of Kentucky Healthcare system. Our inclusion criteria consisted of all adult inpatient admissions from October 1, 2016 through January 31, 2018. We analyzed the use of four ICD-1O codes: E43, E44, E44.1, E46. For financial analysis, we used conservative estimates of the MS-DRG weighted multipliers for fiscal year 2017. Our results showed a decreased trend in the use of un- specified malnutrition, with an increased trend in the use of all categorical diagnoses. Post intervention, 60% of patients who screened positive for malnutrition by the dietitian were subsequently coded with the same diag- nosis by the physician. We saw a 110% increase in the number of visits where malnutrition affected the DRG, which equated to an estimated reimburse- ment value of $822,644 over 6 months (78% increase in reimbursement). These outcomes demonstrate that registered dietitians are a valuable asset to the medical team. Continued education and communication between di- etitians and physicians is necessary to achieve maximum reimbursement. Funding source: None The Distributed Lag Between Alcohol Consumption and Oral Cavity and Pharynx Cancer Rate Author(s): M. Ganjavi, B. Faraji, C. Tucker; Morgan State University Learning Outcome: Participants will learn about the accumulated late effect of alcohol consumption on oral cavity and pharynx cancer rate. Alcohol consumption is a major cause of death worldwide. There are remarkable changes in overall alcohol consumption in different countries including USA. The dose-response relationship of alcohol and cancer has also been investigated in several studies. However, the relationship between the trends in per-capita alcohol consumption in a nation and trends in alcohol- related population-based cancer rates has not been studied yet. The effects of individual drinking behavior on a certain disease are not immediate as they are accumulated over several years. The latent period between exposure to alcohol and cancer diagnosis remains largely unknown. Here, we used Almon distributed lag model to study the late effect of per-capita alcohol con- sumption on different cancer rates. National Cancer Institute (NCI) and Or- ganization for Economic Co-operation and Development (OECD) databases were the sources of data. The SAS software system was used to analyze the data. The Almon polynomial degree and the length of the lag had been calculated by iterations until statistically acceptable results were obtained. It was found that for oral cavity and pharynx cancer, a quadratic model for coefficients and a lag length of 10 years lead to a statistically acceptable re- sults (P-value<0.01). According to this model consumption of w8-10 liter /year (17 -22 g/ day) of alcohol within 10 years before cancer diagnosis was associated with 0.99 cases/100,000 person-year/liter increase in oral cavity and pharynx cancer rate. Distributed lag model technique was found to be applicable to study the effect of alcohol on the cancer rates. Funding source: None Implementing the International Dysphagia Diet Standardization Initiative Framework in Dietetic Curriculum: A Pilot Study Author(s): M. Hall 1 , A. Widaman, PhD, RD 2 , C. LaSalle 1 ; 1 San Jose State University, 2 Department of Nutrition, Food Science and Packaging, San Jose State University Learning Outcome: Upon completion, participant will be able to articulate key features of the International Dysphagia Diet Standardization Initiative Framework, and how it improves upon the previously accepted National Dysphagia Diet. Dysphagia affects 4%- 8% of the general population. Standard practice in the U.S. is based on the National Dysphagia Diet (nectar/honey/pudding thick). However, thickening liquids to subjective descriptors is difficult to do prop- erly; incorrect thickness can lead to aspiration pneumonia. The International Dysphagia Diet Standardization Initiative (IDDSI) uses an objective, culture- neutral framework to evaluate and classify thickened liquids. Different con- sistencies are identified by rate of flow through a 10 ml syringe, then clas- sified using numbers (0 for thin, up to 4 for extremely thick). IDDSI was endorsed by the Academy of Nutrition and Dietetics in January 2017. This experimental study used a convenience sample of 21 senior dietetics students to examine whether hands-on lab training (n¼11) or classroom lecture (n¼10) would improve students’ performance in evaluating thickened liq- uids. The average percent of samples correctly identified in the lecture group was 61% Æ 21%, and 70% Æ 22% in the lab training group. No difference was found between training methods in percent of samples correctly identified (p ¼ 0.985), or number of samples evaluated (p ¼ 0.197). A significant rela- tionship was found between type of liquid thickened (water, juice, or coffee) and percent correct, (p ¼ 0.011), but the percent correct was independent of level of thickness, (p ¼ 0.149). In this small sample, lecture and hands-on lab training were equally effective in disseminating the IDDSI guidelines. To our knowledge this is the first study to evaluate methods for implementing the newly adopted IDDSI Framework into U.S. dietetic student curriculum. Funding source: San Jose State University Circle of Friends Research Grant Comparison of Air Displacement Plethysmography and Dual-Energy X-Ray Absorptiometry for Estimation of Body Fat Percentage in National Collegiate Athletic Association Division I Athletes Author(s): M. Valliant, M. Bass, K. Knight, C. Chenevert; University of Mississippi Learning Outcome: Upon completion participants will be able to describe the difference in ADP and DXA in assessing body commotion and discuss the rationale for using one method versus the other. Body composition, or the proportion of fat, muscle, and bone of an in- dividual’s body, is an important indication of health status. Numerous tech- niques can be used to assess body composition, producing varied results and measurements. Two commonly used techniques for estimating body composition are air displacement plethysmography (ADP) and dual-energy x- ray absorptiometry (DXA). Previous research results comparing ADP and DXA have been inconsistent with the majority finding that ADP overestimated body fat percentage when compared to DXA which is currently considered the reference standard. Additionally, the majority of previous investigations have focused on ideal weight, overweight, and obese adults, not athletes. Therefore, the purpose of this study was to determine whether body fat percentages obtained by ADP and DXA statistically differ from one another, specifically in a lean population. Ninety-three collegiate student athletes participating in Division I NCAA sports underwent an ADP and DXA scan. Using SPSS, paired-sample t-tests were conducted, comparing body fat per- centage estimates from ADP and DXA. Results revealed that body fat per- centages obtained by the ADP were significantly lower than body fat percentages obtained by DXA, with the difference being greater in leaner individuals. These results suggest that different techniques of body compo- sition assessment should not be compared to each other; careful interpre- tation of the results should be taken; and clinical decisions regarding an athletes’ health or participation status should be made using body compo- sition assessed by DXA when possible. Funding source: None A-128 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS October 2018 Suppl 2—Abstracts Volume 118 Number 10 SUNDAY, OCTOBER 21 Poster Session: Professional Skills; Nutrition Assessment & Diagnosis; Medical Nutrition Therapy