MDSRN15

MDSRN15

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All Content by MDSRN15

  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...
  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...
  3. Interrupted stay

    Experts, Need some help with setting ARDs: Entry 3/14 DC to hospital 3/15 Interrupted stay Came back 3/17 THANK
  4. 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
  5. Aetna MCR assessment needed

    Thank
  6. 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....
  7. 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....
  8. 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...
  9. Managed Medicare and HIPPS code

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

    rehab expects both of us to have the same
  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
  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....
  15. PDPM Admission

    Experts, For new PDPM requirement, I understand that Med A admission needs a 5 day, but do I still do an admission assessment to satisfy the OBRA schedule? If I do can I combine like...
  16. PDPM Admission

    Another follow-up with regard to setting ARD: If it is a Managed Medicare, do I separate admission from 5 day assessment? Or I can combine
  17. EOTR

    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...
  18. EOTR

    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...
  19. EOTR

    Chose 1/4 ARD for the EOT and added yes for resumption on 1/8. Thank
  20. Gtube

    Expert, I have a med A resident with a NEW gtube placement, but was done in Barbados. He is 90 y/o, vacationing in his country, had CVA and needs gtube. Came back to US and used Med A in our facility....
  21. EOT - resumption

    Yes. It was 7/28 for an RMC pays for 7/24 - 7/28 THANK YOU VERY MUCH
  22. EOT - resumption

    Experts, I need help setting dates with eot, eop...here's the situation. last day of therapy 7/20 last day of Med A 7/28 missed therapy on 7/21 7/22 7/23...
  23. EOT - resumption

    Can I use 7/28 5th day for SOT-ARD? It says 5-7 days for the ARD. It is also the end of PPS and she was seen that day. Will it apply in the
  24. EOT - resumption

    It turned out, it will only be an RM. How do I get paid for 5 days. See below. 14D --- 7/14 ARD - pays for 7/14 -- 7/20 - RVC20 EOT-R or EOT --- 7/23 ARD - 7/21 -- 7/23 - LD10A SOT??? --- what ARD to...
  25. Care planning Procedure

    Experts, We have a 60 bed subacute in my facility, every week the IDC team schedules to meet with family on Wednesday about 10-15 patients every week. Based on that meeting, they would write on...