New PPS assm't code - OMRA Change of Therapy

[Talino]

we have found some cases where therapy services recorded on a given pps assessment did not provide an accurate account of the therapy provided to a given resident outside the observation window used for the most recent assessment. we believe that when service levels change, whether inside or outside the observation period, such changes should be based on medical evidence... we propose that, effective for services provided on or after october 1, 2011, snfs would be required to complete a change of therapy (cot) omra, for patients classified into a rug-iv therapy group, whenever the intensity of therapy (that is, the total rtm delivered) changes to such a degree that it would no longer reflect the rug-iv classification and payment assigned for a given snf resident based on the most recent assessment used for medicare payment. the cot omra would be a new type of required pps assessment, which would use the same item set as the current eot omra.

federal register /vol. 76, no. 88/friday, may 6, 2011/proposed rules p29

mds 3.0 item subsets v1.00.5 for the october 1, 2011 release

new codes/item:

a0310c - change of therapy

o0450 - resumption of therapy

x0600c - change of therapy

x0900 - end of therapy- resumption date

[iceprincess492]

Awesome....more work and less reimbursement

[rnman99]

Like I don't have enough to do as it is.

[poohmdsnurse]

:uhoh3:Just one more thing for me to add to my do list.... not like it isn't long enough already!!

[susanthomas1954]

No, really, they are finally seeing the actual pitfall of PROSPECTIVE payment? to be honest they are looking in the right place, but let's not use some full assessment. Let's have a one page section "O" for minutes, and have rehab complete it every Friday before they go home, for the last seven days, and we can close and transmit them every Monday morning for every Med A patient. If you're billing an ultra, my dear rehab folks, give 720 minutes a week of therapy. If you're billing a very high, give 500 minutes, and if you go over, try hard as you can to get 720! don't hit 720 on day 11, and never see it agin til day 22. You're busted!!!!!!!