MDS Alert
Stop Sending ABNs To Residents Exceeding The Therapy Cap
Plus: CMS is tweaking the PPS Part A Discharge item set.
Because the recently-passed legislation repealing the Sustainable Growth Rate (SGR) formula also extended the Medicare Part B therapy caps exception process, you should no longer issue advance beneficiary notices (ABNs).
The SGR provisions included an extension for the therapy cap exceptions through Dec. 31, 2017. This means that issuing ABNs to your residents receiving medically necessary services beyond the $1,940 therapy cap is no longer appropriate, according to an April 21 announcement by the American Health Care Association (AHCA)/National Center for Assisted Living (NCAL).
Instead, use the exceptions process for therapy services that exceed the threshold. For more information about ABNs related to the therapy cap, visit www.cms.gov/Medicare/Billing/TherapyServices/Downloads/ABN-Noncoverage-FAQ.pdf.
In Other News …
Check Out 3 New Draft MDS 3.0 Documents
Changes are afoot for several MDS assessments, but don’t get too excited yet — only drafts are available at the moment.
On April 16, the Centers for Medicare & Medicaid Services (CMS) posted three drafts of the MDS 3.0:
1. MDS 3.0 Nursing Home Comprehensive (NC) Version 1.14.0 — www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/Draft-of-the-MDS-30-Nursing-Home-Comprehensive-NC-Version-1140.pdf;
2. Sections A and GG of the MDS 3.0 — www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-SECTIONS-A-AND-GG-DOCUMENT.pdf; and
3. The New MDS 3.0 Prospective Payment System (PPS) Part A Discharge (End of Stay) Version 1.14.0 — www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/Draft-of-the-new-MDS-30-PPS-Part-A-Discharge-End-of-Stay-NPE-SPE-Version-1140.pdf.
You can also access these draft documents by visiting www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/SNF-Quality-Reporting-Program-Measures-and-Technical-Information.html and scrolling down to the bottom of the page for the Downloads section. Note that CMS has not yet determined a proposed effective date for these drafts.
MDS Alert
- Reimbursement:
What The New SNF Quality Reporting Program Has In Store For You
How your hospital readmission rates could soon affect your incentive payments. As all Medicare payments [...] - Surveys:
Prepare Now: What To Expect From The MDS-Focused Surveys
You must provide a plethora of data, just in the first hour of the surveyor’s [...] - Form:
Can You Fill Out This MDS-Focused Survey Worksheet In 1 Hour?
Worksheet is just one document of many that CMS requires from you. The new MDS-Focused [...] - Care Quality:
Brace Yourself For Focused Dementia Care Survey In Your State
Few facilities escaped the pilot surveys without deficiency citations. As if you didn’t have enough [...] - Section H:
Don't Let 4 Coding Conventions For Bowel/Bladder Appliances Trip You Up
Mistake: Intermittent catheterization does not include straight catheter for urine sample. At first blush, coding [...] - Section G:
Learn From 5 Section G Tips To Advance Your ADL Coding
Don’t include these functional factors when coding items. When it comes to coding Activities of [...] - Assessments:
Clear Up Your Confusion Over SCSAs & Hospice Services
Know when you need to complete only the Admission assessment. In most cases, you will [...] - Industry News to Use:
Stop Sending ABNs To Residents Exceeding The Therapy Cap
Plus: CMS is tweaking the PPS Part A Discharge item set. Because the recently-passed legislation [...]
