MDS Alert
MDS & BILLING NEWS TO USE
CMS addresses nitty gritty MDS and billing issues at recent SNF Open Door Forums. Ready for some RUGs refinements? Providers can look for a Centers for Medicare & Medicaid Services' report to Congress in January 2005, according to an agency representative speaking at a recent SNF Open Door Forum (ODF). CMS also tackled the provider question: If a SNF provides an end-of-life program, does that count for purposes of coding hospice care in Section Pon the MDS? The answer: To code hospice care, the hospice provider must either be licensed by the state as a hospice or certified under the Medicare program as a hospice provider. Also, keep those ink pens flowing: CMS isn't ready to handle electronic signatures on the MDS yet, said Sheila Lambowitz, deputy director of the division of institutional long-term care and the new ODF chair. Facilities that provide services subject to consolidated billing under arrangement must have a written agreement with the providers/suppliers providing the services or items. That's according to CMS Transmittal 183 (change request 3248), with a July 1, 2004 effective date. Read the transmittal online at http://63.241.27.79/manuals/pm_trans/R183CP.pdf. Does your SNF know how to bill the extra RUGs payment for AIDS patients? Part Astay SNF residents with AIDS get 128 percent of their RUG payment, effective Oct. 1, thanks to a provision in the Medicare Modernization Act of 2003. To obtain the extra payment, SNFs must bill diagnosis code 042 (HIV-related illness) on the UB-92. The add-on will apply to any RUG for which a patient with AIDS qualifies, according to a CMS official.
Yet the extra payment won't begin to cover the basic SNF costs of care for such patients if they are receiving antiretroviral therapy, notes Christine Hurley, executive director of Bailey-Boushay House, a Seattle facility specializing in AIDS care. "Most patients with AIDS are dually eligible for Medicare and Medicaid."
Do you have a question about the AIDS add-on? The toll free number for your intermediary can be found online at www.cms.hhs.gov/medlearn/toll-nums.asp.
MDS Alert
- Medicare Payment:
Estimate Therapy Minutes Without Penalizing Residents,Your Ledger - Or Rousing DAVE
8 steps to crossing Section T off your worry list. Is your facility pulling rehab [...] - Diagnosis Coding Update
Coding Section I Would you code a diagnosis of quadriparesis at item I1z (quadri-palegia - [...] - Clip 'N Save:
Follow These Directions For Coding Section T1 (Estimated Therapy)
T1c. ESTIMATE OFNUMBER OFDAYS (first 14 days through day 15) Coding: Estimate of Number of [...] - RAI Manual Update:
Nail Down The Latest Coding Changes For Restorative, IVs And Wounds
Heads up:Some changes affect payment or provide helpful clarifications. As an MDS coordinator, you're only [...] - MDS Coding:
4 Helpful Clarifications To MDS Coding Instructions
The April 2004 RAI user's manual update contains some language changes that clarify a number [...] - What Do You Think?
Question: If an IV or IV med is administered to the resident as part of [...] - MDS Data Integrity:
Stave Off DAVE Or Face Payment Recoupments - Or Worse
Follow these strategies for turning this government watchdog into friend rather than foe. The government's [...] - Clip 'N Save:
Section G - DAVE Crosswalk (from Computer Sciences Corporation) - Case Study:
Sometimes Less Definitely Is Better - Especially When It Comes To Assessment Forms
TSW facilities only supplement MDS assessment as needed. A nursing facility doesn't have to use [...] - Coding Quizzer:
Coding Activities of Daily Living
How would you code this ADL example revised in the April 2004 RAI user manual [...] - MDS & BILLING NEWS TO USE
CMS addresses nitty gritty MDS and billing issues at recent SNF Open Door Forums. Ready [...]
