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Discussion

Start of Theray

We had a new admission on 2/17 and pt had to be sent to the hospital on 2/19. We opened a 5day assessment/ SOT and DRNA separately since pt is manage/Level. I couldn't close my 5 day assessment. I was expecting it since the 5 day assessment does not have rehab rug.

Pt had non theory rug: ES2. I am always confuse when it comes to OMRA assessment. Now our MDS leader is asking me just to answer yes for A2400 as medicare to be able to close it.

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Do you mean the primary payer is Managed Medicare? If so, do not combine the 5 day / SOT with the DCRA. The DCRA has to be transmitted, the 5 day/SOT does not. You can copy the DCRA when complete and code it as SOT/5-day. Just fill in the remaining items.

In order to do SOT/5-day, A2400A must be Yes, even though the payer is actually not. This is only to trick the software. The assessment will not be submitted anyway.

What Rehab RUG are you expecting? ES2 may pay more. Albeit, most Managed Medicare products pay a standard precontracted rate regardless the RUG score.

  • Author

Hi Talino,

Yes, Pt is managed medicare and I did not combine DCRA with 5 day since we don't submit the pps assess with manage rug or level . However I was having trouble to close the SOT/5D-day assessment. Thanks to you now I know the trick, again you saved me.

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