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Eli's Rehab Report
Eli's Rehab Report
Eli's Rehab Report - 2014; Volume 15, Number 12
ICD-10:
Get a Big-Picture Rundown of ICD-10 Prep
Important: Not all payers will be ready at the same time. What was once an Oct. 1, 201...
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Coding Corner:
2 Clinical Examples to Get Your Feet Wet in ICD-10
Careful: Crosswalks can be your best friend — or worst nightmare. ICD-10 codes a...
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Vocal Pathologies ICD-10 Example
J38.0: Paralysis of vocal cords and larynx Laryngople...
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SNF Therapy:
Use New Policy Changes to Your Advantage
Confusing clarifications in revised RAI Manual threaten reimbursement. Having trouble ...
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Home Health Therapy:
CMS Ditches Visit-Based Reassessment Timeline
Therapists and HHAs rejoice in the streamlining of therapy reassessment standards in the...
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Final 2015 Per-Visit Amounts For Home Health LUPAs and Outliers
As urged by numerous commenters, CMS has “reweighted some of the impact of therapy...
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Industry Notes:
Therapy Legislation Could Facilitate Telemedicine Reimbursement
Home health agencies that furnish Part B outpatient therapy in the home should keep thei...
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Eli's Rehab Report - 2014; Volume 15, Number 11
Inpatient Insights:
Gauge the 'IMPACT' of New Post-Acute Care Standardization Law
The stage has been set for payment reform. Lawmakers have prompted a re-modeling proje...
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Practice Pointers:
6 Ways to Point Your Compass toward IMPACT ACT Changes
Proving the value of therapy in your setting will be key. Think there’s nothing ...
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Home Health Prospective Payment System:
CMS Plans to Dump the Current Byzantine Visit Counting Requirement
Therapists and agencies prefer a time-based schedule. Commenters welcome the eliminati...
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Home Health Therapy:
Timeline for Therapy Reassessment Needs to be Realistic, Say Commenters
CMS determination to curb revenue maximizing efforts by certain agencies could backfire....
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Industry Notes:
MAC Denies 40% of Claims in Home Health Therapy Reviews
More than 70% of denied claims were due to F2F in a recent probe. Whether Medicare will ...
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Home Health Regulations:
Therapists Overwhelmed by Paperwork
Quality of patient care suffers. The frequent reassessment visits required by CMS&r...
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Eli's Rehab Report - 2014; Volume 15, Number 10
Legislation:
Track the Latest Telehealth Trends Heating Up the Rehab Scene
Healthcare industry sees more momentum than ever in Congress for widespread coverage. ...
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Coding Corner:
Choose Your Codes Wisely for Remote Services
You might have to avoid the 97000 series altogether. While Medicare may not cover tele...
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States' Coverage:
Use Remote Technology Regardless of Medicare Coverage
Check out the parity laws. Congress pushed for more Medicare coverage of telehealth in...
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Severity Modifier Coding:
Solidify Your Physiotherapy Coding Knowledge
Refresher: Unless you remember to add the required functional G code/modifier, your clai...
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SNF Reimbursement:
Get A Healthy Payment Boost Next Year
Geographic location will define the exact payment increase. The Centers for Medicare &...
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ICD-10 News:
Mark Your Calendar, Officially
You have just over a year to prepare. As you were turning the calendar from July to...
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Eli's Rehab Report - 2014; Volume 15, Number 9
Outpatient Outlook:
Think FLR Is Limited to Medicare Claims? Think Again
UnitedHealthcare attempts to join the bandwagon. Just when you’ve gotten a grip ...
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IRFs and SNFs:
Equip Yourself for 2014 PPS Updates Now -- and Prevent Headaches Later
Group therapy now being monitored in both SNFs and IRFs. The Centers for Medicare &...
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SNFs:
Use MDS to Put Documentation, Rehab Outcomes On Track
Find missed care opportunities, unexpected decline, inconsistencies. Try targeting spe...
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Patient Privacy:
Protect Your Organization From Breach Risks
Avoid getting into hot water — don’t delay reporting a breach. You need to...
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Industry Notes:
Intervene Early with Childhood Communication Disorders
There has been an alarming rise in disability associated with speech problems in childre...
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Eli's Rehab Report - 2014; Volume 15, Number 8
Outpatient Outlook:
Expect a High Focus on Value from CMS in 2015
Agency proposes PQRS changes and more in proposed MPFS. The proposed Medicare Physicia...
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Long Term Care:
Explore 2 Likely Payment Models for SNFs in the Near Future
Therapy minute-based payments are on the outs. CMS has hinted at payment reform for sk...
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Inpatient Insights:
Learn More About Proposed Changes for IRFs
Get on-the-ground insight on IRF-PAI and quality reporting changes. Medicare&rsq...
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Home Health Therapy Reassessment:
Look to 2015 PPS Rule for Possible Reprieve
Tracking days instead of counting visits proposed. The Centers for Medicare & Medi...
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Long-Term Care:
Restorative, Rehab, or Both? The Wrong Answer Can Cost Your SNF
4 quick questions can keep your care and payment on track. Your skilled nursing facili...
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Practice Pointers:
Amp Up Your SNF Therapy Documentation With the Right Details
Use this gait training example as a model. So your SNF has decided to go with rehab th...
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Industry Notes:
Use of Standardized Data Across Post-Acute Care Settings On The Horizon
You can look forward to standardization of data soon, which should come as a relief to p...
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Reader Question:
Do This for a PT and OT Coding Crossover
Question: What happens if physical therapy and occupational therapy is working on t...
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Reader Question:
What Kind Of Risk Does Using Private Email Accounts Pose?
Question: Our provider group has a secure system for encrypting all outgoing emails...
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Eli's Rehab Report - 2014; Volume 15, Number 7
Inpatient Insights:
Proposed IRF Rule Could Tighten 60% Rule Even More
Plus: You may see 2 new items on the IRF-PAI next year. The Centers for Medicare &...
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Skilled Nursing Facilities:
Rehab Could Land New Opportunity With COT OMRA Proposal
SNF PPS changes small for now, but big plans on the horizon. The Centers for Medicare ...
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Medical Review:
Help Home Health Partners Avoid Probe Edits
Improved communication with nursing staff is the key. The Medicare Administrative Cont...
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ICD-10 Readiness:
Avoid Going Off The Cliff During The ICD-10 Transition
Take the time to learn from those who are already using ICD-10. Did you heave a sigh o...
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Industry Notes:
Watch For The Most Comprehensive Physical Therapy Electronic Repository To Date
The American Physical Therapy Association (APTA) has announced on June 10, a new collabo...
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Reader Question:
Know When To Combine The 30 Day Assessment With a COT
Question: If a resident is scheduled for their 30 day assessment on day 27 of the M...
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Reader Question:
Put Initial Assessment First
Question: I have a question about the order of visits in a new episode when there a...
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Reader Question:
Know Who Can Perform Nerve Conduction Studies
Question: I’m looking for guidelines regarding who is a qualified healthcare provi...
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Eli's Rehab Report - 2014; Volume 15, Number 6
Practice Pointers:
Put Your Documentation Under the Microscope for ICD-10 Prep
Get a fresh perspective of the documentation demands that come with ICD-10. ICD-10 imp...
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HIPAA:
Are You Leaving PHI Vulnerable to Breaches?
Compliance review leads to startling settlement. When the Office of Civil Rights (OCR)...
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Office Guidelines:
Keep These Supervision Requirements In Mind
Add your state’s laws to complete the guidance. Scouring the Medicare Claims ...
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Staffing Strategies:
Create A Winning Combination By Investing In Staff Education
Use these 4 ingredients for staff development success by engaging staff in multiple trai...
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Industry Notes:
Lack Of OASIS Support #1 Home Health Denial Reason
Lack of documentation for OASIS M0 items edged out face-to-face as the chief reason for ...
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Reader Question:
Explore Possibilities for Gait Training Denial
Question: We have been billing 97116 for gait training with no problem until earlie...
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Reader Question:
Evaluation And Assessment Differ
Question: I have a question for physical therapy codes 97001-97002. Our patient cam...
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Reader Question:
Billing 97001/97003 With 97542? Know This First
Question: In my fiscal intermediary’s local coverage determination (Cahaba GB...
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Eli's Rehab Report - 2014; Volume 15, Number 5
Outpatient Outlook:
Congress Cuts It Close With Last-Minute SGR Patch
Plus: Legislation shocks providers with ICD-10 delay. Relish in the relief that ...
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Reimbursement:
Therapy Cap Exceptions Extended One Year
KX modifiers are back. If you furnish outpatient therapy in the home under the Part B ...
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Modifiers:
Clear Up Modifier Confusion
Tip: Watch for CCI edits in case of denials. Are you over-using modifiers? Make certai...
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Keep Track Of Functional Limitation G Codes
The following Healthcare Common Procedure Coding System (HCPCS) G-codes are used...
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MDS 3.0:
Count Therapy Dates Based on ARD
Changes to Section I & O still in draft stage. If you’ve been gearing up for...
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Acute Rehab:
Are Inappropriate Referrals Bogging You Down?
Get tips on more efficient patient screenings for therapy. If you work in an acute reh...
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Health and Wellness:
Quick Test: Are You a Positive or a Negative Coper?
Reduce stress with these positive coping skills. When things get crazy at work, do you...
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Reader Question:
Consider Before and After Time When Patient Takes a Break
Question: How should I bill for a patient who performed 20 minutes of therapeutic e...
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Reader Question:
Watch Tax ID for Same-Day PT and Other Service
Question: We bill physical therapy under a physician number, not a facility. If one...
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Eli's Rehab Report - 2014; Volume 15, Number 4
Coding Corner:
Kick Your ICD-10 Preparation Into High Gear in 5 Steps
Critical point: You’re only 6 months out from a new diagnostic coding reality. T...
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SNF Therapy:
Don't Arbitrarily Stagger Timing Of Therapy Modalities
Be prepared for potential Additional Documentation Requests for the lower 14 RUG categor...
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Home Health Therapy:
Are Your OASIS Responses Putting Your Claims At Risk?
Tip: Communication problems between nurses and therapists could be at the root of the pr...
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3 Examples Show You How To Count Therapy In SNF Look-Back Period
How new item O0420 will change your RUG classification. When the Centers for Medica...
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Industry Notes:
Know Your Therapy Modifiers for Claims Success
Therapists who have been submitting claims to Medicare with the therapy modifiers for th...
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Target these Home Health Communication Hotspots to Prevent ADRs
When it comes to preventing problems with your high-therapy claims, making certain every...
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Reader Question:
When Should You Do a Change in Therapy for a SNF Resident?
Question: I am still confused about when to do a Change in Therapy (COT). I was un...
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Eli's Rehab Report - 2014; Volume 15, Number 3
Outpatient Outlook:
Heads Up: SGR Fix in Home Stretch, Therapy Cap Repeal Lags Behind
Upcoming committee focus on HR 4015’s extenders offers ray of hope. Therapists m...
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Inpatient Insights:
Stop Hospital Readmissions in Their Tracks With This 7-Point Checklist
Hint: The biggest cause of readmissions is not related to the admitting Dx. Did you kn...
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Home Health:
Take A Collaborative Approach For Completing OASIS
Tip: Complete the drug regimen review each time you conduct the comprehensive assessment...
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Staffing Strategies:
Improve Internal Communication With This Easy 4-Step Strategy
Start evaluating and then enhancing your communication system. Excellent communication...
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Clip and Save:
Improve Home Health Medication Management with this Teaching Tool
Help your patient remember to tell you when medication issues arise. It’s import...
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The Do's And Don'ts of Listening
Do’s: Clear your schedule and make time to listen to the person. Ask the o...
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Industry Notes:
Manual Changes, Education Call Shed Light On Change In Improvement Standard
If you’re trying to get a handle on what the Jimmo settlement agreement means you&...
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Eli's Rehab Report - 2014; Volume 15, Number 2
Outpatient Outlook:
Hold Fast -- But Not Tight -- to Latest SGR, Therapy Cap Fix
Historical legislative overhaul for payment policy may come as soon as April. Congress...
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Coding Coach:
Make Coding for Pelvic Floor Muscle Rehabilitation Services A Snap
Tip: Ensure you can justify PFMR. Treating stress urinary incontinence (SUI) with nons...
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Hospitals:
Get the Facts Straight on Therapy Caps and Hospitals
Pathway for SGR Reform Act nails CAHs, but may be only temporary. Hospitals have seen ...
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SNFs:
Adjust Therapy Schedules to Budget for Residents' LOA
Avoid decreased reimbursement with thorough documentation. According to the Medicare B...
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ICD-10-CM:
Big Change for Home Health Coders in Aftercare Coding
Heed therapy coding changes which take effect in October this year. Adopting the ICD-1...
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Industry Notes:
Industry Notes:
Mark Your Calendars: CMS Sets March 3-March 7 As ICD-10 Testing Week If you worry abou...
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Eli's Rehab Report - 2014; Volume 15, Number 1
Outpatient Outlook:
Expect a Near Miss of Steep Medicare Payment Changes
You may be in therapy cap and SGR limbo between January and March. Industry leaders a...
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Practice Pointers:
Nail Down the Final Changes for 2014 PQRS
Don’t miss: More measures now needed to qualify for your 0.5% bonus. Along with ...
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Dysphagia Coding:
Base Your Dysphagia Coding on Details
Make correct choices based on our experts’ advice. Dysphagia (difficulty in swal...
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Reimbursement:
CMS Uses ACA to Justify Cuts in LUPA Payments
Commenters express a wide range of concerns about LUPA payments. Home health agencies ...
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Proposed 2014 Per-Visit Amounts For LUPAs and Outliers
Discipline 2013 Per Visit&n...
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Mood Management:
Don't Let Events Get the Better of You
Here’s how to stay chilled when the pressure’s on. Make a personal connect...
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Industry News
Mark Your Calendars: CMS Sets March 3-March 7 As ICD-10 Testing Week If you worry abou...
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Reader Question:
Accuracy, Not Sequencing, Required for Claims
Question: Do you know if Medicare requires modifiers to be in a specific order? For exam...
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Reader Question:
When Are Re-Evaluations Reasonable and Necessary?
Question: I’m wondering when therapy re-evaluations are considered reasonable and ...
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Reader Question:
Don't Allow Anyone to Bully You
Question: Often, I find myself dealing with some really rude patients. Some bully me on ...
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