MDS Alert
You Can Utilize 'Medically Complex' for Primary Diagnosis
Question: I have a resident who has numerous chronic diseases, some of which are better managed and less symptomatic than others. This resident has Type II diabetes, HIV, and now pneumonia. The HIV is managed well and does not seem to affect this resident’s daily life. The diabetes and pneumonia are much more of an issue — complications from the diabetes landed this resident in our facility in the first place. How would I code the primary medical condition for item I0020 (Indicate the resident’s primary medical condition category) in Section I (Active Diagnoses)? Codify Subscriber Answer: “For I0020, I would code 13 since he is Medically complex,” says Ronald A. Orth, RN, NHA, CPC, senior SNF regulatory analyst at Relias Learning in Milwaukee, Wisconsin. “I0020 and the AIDs Add-on are not related. You gain nothing by putting the B20 diagnosis code in I0020A,” he adds. However, with facilities have been able to bill at a higher rate for residents with HIV/AIDS, including with the current RUG-IV reimbursement categorization. See story on page XX for more information on how the Patient Driven Payment Model (PDPM) may affect facility reimbursement for residents with HIV/AIDS.
MDS Alert
- PDPM Focus:
PDPM May Affect HIV/AIDS Reimbursement Adjustment
Will switch from therapy billing in RUG-IV to include nursing in PDPM adequately cover the [...] - Section I:
Be Careful How You Document HIV/AIDS
Hint: Defining illnesses may be key. If you are caring for a resident with HIV/AIDS [...] - MDS Best Practices:
MDS Section Assignment: Who Does What
See how different facilities across the country assign different sections of the MDS and find [...] - Long-Term Care Industry at Large:
Battling Grief in the Workplace
Death is part of life in the long-term care industry, and acknowledging it can help [...] - See How Other Facilities Honor Resident Deaths
Individual facilities and staff members respond differently to resident deaths. If you believe your facility [...] - ICD-10 Focus:
Code Pressure Ulcers Like This
Sequence, then specify site, side, and severity for success. When residents spend a lot of [...] - Reader Question:
You Can Utilize 'Medically Complex' for Primary Diagnosis
Question: I have a resident who has numerous chronic diseases, some of which are better [...] - Reader Question:
Include Care Plan When Transferring Resident
Question: I work for a skilled nursing facility and we have a resident transferring to [...] - Reader Question:
Implement Data Safety Plan Before Terminating Employees
Question: With so much turnover at our facility, I worry about residents’ protected health information. [...] - Reader Question:
Have a Plan for Decommissioning Old Devices
Question: Our facility is purchasing new smartphones for some key employees, including some of the [...]
