EOTR

  1. Need some experts on this:

    5D - 1/3
    refused rehab starting 1/4 - HC1
    started back again on 1/8
    14D/COT - 1/14 as per rehab - RHA

    Where do I set the EOT-R, or I just check-off EOTR on section O?

    THANK YOU!
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    About MDSRN15

    Joined: Feb '15; Posts: 48; Likes: 1

    4 Comments

  3. by   Talino
    EOT ARD between 1/4 - 1/6
    O0450A - Yes
    O0450B - 1/8
  4. by   MDSRN15
    Chose 1/4 ARD for the EOT and added yes for resumption on 1/8.

    Thank you.
  5. by   MDSRN15
    My biller is saying that I do not need the EOT because I got nursing RUGS. Not sure how to go about this.

    5D - 1/3 - HC110
    EOT-R - 1/4 - HC10A ---- not needed??? I think I need it to do the resumption.
    14D/COT - 1/14 - HB12D
    30D/COT - 1/28 - RVA3D
  6. by   Talino
    The EOT is only required if the 5-day yielded a Rehab RUG. Since it did not, the biller is correct. Inactivate the EOT.

    The optional SOT with ARD 5-7 days after the resumption of Rehab, may have been the correct assm't that would have fallen on the same window of the 14D. But seeing your 14D/COT is still non-Rehab, the SOT is null.

    Of note, your 14D/COT yielded a lower RUG than the 5D. Whenever the COT checkpoint falls on the same window of a scheduled PPS and the RUG score is lower, there is no need to combine the COT. In your case, just do the 14D. Hence, HB12D payment begins on day 15. Since the 14D and COT was combined, HB12D begins 1/8, 7 days early.

    Since the RUG score went up, the 30D/COT is correctly combined.

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