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Messed up ARD?

Posted

I'm new to MDS and the experienced MDS recently quit. I have a patient that has insurance and primary payer source. On the 5 day ARD date I added the Admit assessment, but I added it as an OMRA instead of PPS with the 5 day start date. I attempted changing it from OMRA to PPS, but it wouldn't allow me to do so, because the 5 day was closed. What can I do to change this and get it back on schedule?

Talino

Specializes in ER CCU MICU SICU LTC/SNF.

OMRA is Other Medicare Required Assm't - COT, SOT, EOT so you meant OBRA (Adm, Annual, Quarterly, etc)

Insurances, like Medicare Advantage organizations, only require the HIPPS code (Z0100A) obtained from an MDS assessment. However, when creating MDS assessments for this purpose, the MDS is not to be submitted.

Therefore, the 5-day cannot be combined w/ the Admission MDS. So you need not worry about the omission which was serendipitously correct. Just use the HIPPS code (Z0100A) calculated by the Adm MDS to bill.

If the insurance also requires the HIPPS from the 14D, 30D, etc. go ahead and do them. Just remember NOT to submit these assm'ts.

Locked Assessment:

Your software should allow changes to the MDS during the encoding period (the time after the assessment is completed and prior to submission). Some software will unlock the assessment when you clear the signature in Z0500A. Ask your vendor. This can just be a security feature that the MDS coordinator should be granted privilege.

If the 5-day was a true PPS assessment (traditional Medicare) that needed to be submitted and you cannot unlock the assessment, just submit the Adm MDS as is. Once accepted, you can do a modification. You can now add the 5-day to the Adm MDS.