MDS Alert
Is Your SNF Missing Out on RUG Payment forWounds or Rx?
If you don't code certain wounds or treatments, your payment may suffer. Your facility may do a good job of capturing pressure ulcers on the MDS, but what about other skin wounds or lesions that can affect RUG placement? And even if you code wounds correctly, if you don't code related wound care interventions, your SNF may not be receiving fair payment. Wounds and wound treatments coded on the MDS could put the resident in Special Care, says Nathan Lake, RN, BSN, an MDS expert in Seattle. If the resident had IVs or other extensive service indicators and went into Extensive Services, then qualifying for Special Care would affect the extensive count. Nail down the RUG drivers: The resident may RUG into Special Care if he has the requisite ADL score and one of the following: M1a,b,c,d Ulcers 2+ sites over all stages with 2 or more skin treatments** M2a Any stage 3 or 4 pressure ulcer with 2 or more skin treatments** M4g,M4c Surgical wounds or open lesions with 1 or more skin treatments*** **Skin treatments: M5a, b# Pressure relieving chair and/or bed M5c Turning/repositioning M5d Nutrition or hydration intervention M5e Ulcer care M5g Application of dressings (not to feet) M5h Application of ointments (not to feet) #Count as one treatment even if both provided ***Skin Treatments M5f Surgical wound care M5g Application of dressing (not to feet) M5h Application of ointments (not to feet) Source: RAI User's Manual.
MDS Alert
- MEDICARE :
CMS Rolls Out New RUGs With Significant Changes
Extensive Services to include only vents, trachs, isolation for active infection. The proposed SNF PPS [...] - PPS Analysis :
Industry Insiders Highlight the Good, Bad and Unknowns to the Proposed RUG-IV
The ADL index range change could be a boon. Industry leaders view the proposed RUG-IV [...] - Brace for a Part A Payment Cut on Oct. 1
The case-mix adjustment recalibration is back. If you hoped the Centers for Medicare & Medicaid [...] - MEDICARE :
Take a Look at Part A Current Concurrent Therapy Now
The handwriting appears to be on the wall for this modality. When CMS expresses concerns [...] - RESOURCE :
Find Out How the New RUGs Break Out
Chart shows RUG-IV categories and ADL splits. - MDS 3.0 :
CMS Unveils a New Draft MDS 3.0 Data Item SetWith ADL Changes and CATs
Find out 2 key differences in this latest version. The month of May proved to [...] - ADL CALCULATION :
Take a Look at the Draft MDS 3.0 Revised ADL Calculation - RAI COMPLIANCE :
Get the Inside Skinny on Coding Skin Ulcers on the MDS
Follow these inside tips to boost accuracy. Painting an inaccurate picture of residents' skin ulcers [...] - PAYMENT TIP :
Is Your SNF Missing Out on RUG Payment forWounds or Rx?
If you don't code certain wounds or treatments, your payment may suffer. Your facility may [...] - DIAGNOSIS CODING :
Know How to Code Non-Pressure Type Ulcers in Section I3
Get it right with these key ICD-9 coding principles. Sometimes you have to think outside [...] - PAIN MANAGEMENT :
Meet and Exceed Residents' Pain Management Expectations
A 3-step approach will improve care and rein in your pain QMs. A cognitively intact [...] - MDS ACCURACY :
KnowWhen You've Entered the No-Code Zone
Master this short list to keep your RUG-III scores on the up and up. Is [...] - Proposed RUG-IV System :
Check Out Proposed RUG-IV Drivers for Special Care High and Low, and Clinically Complex
Special Care High includes residents with an ADL score greater than or equal to 2 [...] - READER QUESTIONS :
To Give an ABN or Not for a Part B Resident Who's Exhausted the Therapy Cap
Question: Should our facility give a beneficiary the CMS-R-131 when the resident has exhausted the [...] - READER QUESTIONS :
How to Code the Number of Meds at O1 Accurately
Question: What are the key mistakes facilities make in coding the number of medications at [...]
