MDSRN15

MDSRN15

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  1. Re-opened wound

    Experts, Clarification please! I have a stage 3 sacral pressure ulcer that healed 2 years ago, now I have a new redness on the sacrum, is it the same Stage 3? OR a new pressure ulcer. Thank you!
  2. Waiver

    Can you clarify the use of the extra 100 days under the 1135 waiver. * Resident has exhausted her 100 days. *Just went out again for new pacemaker, can I use the extra 100 waiver without any covid dx? Separate question: * Do I do ...
  3. Interrupted stay

    No dc on 3/15 with interrupted stay checked off then re-entry with an ARD of 3/21 ???? I'm so confused with rules
  4. Interrupted stay

    Experts, Need some help with setting ARDs: Entry 3/14 DC to hospital 3/15 Interrupted stay Came back 3/17 THANK YOU
  5. Aetna MCR assessment needed

    Thank you!
  6. Aetna MCR assessment needed

    Experts, Need help on how to set an assessment with this unique scenario. 1. LTC resident got an authorization from Aetna Mcr to cover her recent Covid with symptoms. 2. Hospitalization was waived as per CMS guideline. 3. What a...
  7. Covid and Med A

    Experts, We have LTC residents that has contracted covid, can I use Med A benefits without hospitalization? I saw a note in this CMS, but I want to make sure. https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care If its t...
  8. IPA and restorative

    Experts, Can adding 6 days of restorative for a Med A patient affect an IPA? Not sure if it will increase reimbursement or at least stay on the same HIPPS payment without the 2% reduction. Thank you!
  9. Managed Medicare and HIPPS code

    Hard to teach. I'll stay in my desk. Thanks.
  10. Managed Medicare and HIPPS code

    I wish I can paste an image, but I did created an admission assessment and I have an icon that can calculate a PDPM and RUG at the same time on this assessment. So, I can create a 5D with a HIPPS, submit to biller and its ok to have an admission subm...
  11. Managed Medicare and HIPPS code

    Since our United plans pay using PDPM, then I have to create an admission then a stand alone 5D with GG filled out, please confirm. Wouldn't it be fraud since I'm submitting a different information to CMS and I'm billing a different one?
  12. Managed Medicare and HIPPS code

    rehab expects both of us to have the same HIPPS.
  13. Managed Medicare and HIPPS code

    I can calculate it automatically in my system. Did not combine assessment. So, when I create a standalone 5D as you stated I should dash-out GG, but rehab factors it out to create their HIPPS.
  14. Managed Medicare and HIPPS code

    Follow-up on this Ms. Talino: 1. Received a letter from United MCR plans that they will use PDPM rules for billing. 2. Rehab follows PDPM and sets more minutes. Rehab then bills on a higher rate. 3. Submitted an admission assessment to CMS and create...
  15. Managed Medicare and HIPPS code

    Experts, I have a resident with Aetna Managed Medicare, what assessments do I need to open. Biller needs a HIPPS code as she said AETNA adopted the PDPM rule. Thank again for all the help from these confusion ?