ibtootie (3,038 Views)
Joined Dec 27, '10.
Posts: 77 (5% Liked)
This solely depends on the MA plan. 'though some may require a RUG score to pay, majority demands clinical documentation only. If a plan does require a RUG score, I strongly doubt they adhere to the same stringent PPS requirement for ARD windows.
30 days is correct. Our policy is within 5 days. The physician must sign the orders, not the NP.
I have the regulation hanging on my wall at work. I'll post it here tomorrow.
I say you can choose day 5, 6 or 7 for 5-day ARD, combined with EOT( day 1 , 2 or 3 from last day of therapy). No SOT because it is not a short stay. No COT Observation follows because therapy had ended. You will get paid rehab RUG for days 1-4 when therapy is on, then nursing RUG for day 5 (10/15) onwards considering the patient is still skilled for IV meds and surgical wounds/post amputation.
Well, doing an EOT will only depend on what that first RUG is, if it is a rehab RUG then yes you will need it, if there aren't enough minutes, or the ADLs are low the initial RUG may be a nursing one, in that case, an EOT to switch from rehab to nursing isn't required.
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