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MDS Alert

Medicare Payment:
The Resident Is RUGing Into What?!
Understand how the RUG grouper selects a RUG when a resident's MDS qualifies him for more ... Read more
Medicare Payment:
Head Off A Fiscal Fall--Know What's Behind A Resident's RUG Placement
Take these essential steps to see if your RUG payment is on track.If a resident doesn't RU... Read more
Payment Trends:
Time For Another Time Study--CMS Pushes To Get The RUG System Up To Speed
CMS to consider high-cost ancillaries.Imagine a revamped set of RUGs that reflect more acc... Read more
Consolidated Billing:
5 Ways To Cut Your Losses Under Consolidated Billing
Put the plug in this potential payment drain.What little the PPS giveth for some RUGs, con... Read more
RAI Compliance:
Don't Confuse Consolidated Billing With MDS Coding Rules
Excluding an excluded service on the MDS can cost you a RUG.You want to code everything yo... Read more
MDS Coding:
Cover These Bases In Coding A Resident On Palliative Care
Otherwise, you could end up with a losing survey or QIs/QMs out of bounds.The MDS may not ... Read more
Coding Quizzer:
Determine Discharge Potential For The Dying Patient
Coding discharge potential at Q1 for a resident at the end of life can be tricky. How woul... Read more
Quality Reporting:
Coding End-Stage Disease Excludes Residents From These Quality Measures
If the Centers for Medicare & Medicaid Services gives you a break in your quality repo... Read more
Section W:
Worried About Lack Of Coding Options To Explain Immunizations Offered But Not Yet Given?
Here's the posted solution for now.The Centers for Medicare & Medicaid Services' has h... Read more
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Code Sections A9, A10, Correctly
Take a close look at these questions.... Read more
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See How The RUGs Stack Up Under CMI Maximization
The RUG-53 SNF PPS CMIs for rural (C03) and urban (C04) facilities are presented in the fo... Read more
MDS & Billing News
DAVE is making a comeback. Pronouncements of DAVE's demise were apparently exaggerated. Th... Read more
Medicare Payment:
Take Steps So The New RUGs Don't Trip You Up
Ramp up now for the revamped RUG systemStarting Jan. 1, the RUGs will expand from the curr... Read more
Coding Quizzer:
Know The Definition Of Abnormal Labs At P9
How would you code this example?Mrs. J is receiving Coumadin for DVT. She has elevated pro... Read more
MDS Coding:
Master Nuances Of Coding Flu Immunization In Section W2
The new section requires a step-by-step process to complete correctly.If you're still wond... Read more
Resident Assessment:
Climb The Decision-Making Tree For W2b
Cover these bases to ensure residents receive flu vaccination.To code W2 correctly and boo... Read more
Case Study:
Follow This Facility's Lead To Validate IVs And Other Treatments In Hospital Lookback
Get your documentation in a row for the new RUG system.If you don't want to be held captiv... Read more
Medicare Billing:
Shake Loose The Old RUGs From The New For Assessments Spanning 2005-2006
If you don't, you can get hit with payment recoupments.As the new year approaches, ringing... Read more
Medicare Compliance:
Protect Your SNF Against Fiscal Illness--Code Physician Visits, Orders Correctly
Undercoding P7 or P8 can cost your resident a RUG.Physician visits and orders can be a RUG... Read more
What Do You Think?
Should SNFs and NFs schedule medically necessary physician visits during a resident's PPS ... Read more
Medication Review:
Let Section O Open The Door To Improved QIs, Care Planning
Did you know Section O packs this wealth of info?Take a close look at Section O, and you w... Read more
RAI Manual Compliance:
Include These Items On Your 'Do Not Code List' For P7, P8
Use this 'cheat sheet' to avoid accidentally cheating MedicareStamp out compliance woes an... Read more
MDS News To Use
If you obtain a National Provider Identifier (NPI), make sure to enter it correctly at W1.... Read more
MDS Coding:
5 Ways To Keep Your ADLs On The Money And Off The F Tags
Catch little errors before they cost you a RUG or a clean survey.Inaccurate ADL scoring ta... Read more
MDS Coding:
Beware--Little ADL Coding Missteps Will Rip Your RUGs
Add dollar signs to your argument for investing in MDS accuracy. ADLs drive RUG classifica... Read more
Training Tip:
Target Coding Woes Before They Morph Into Systemic Issues
Ready, aim, educate.To keep your MDS documentation on track, you have to show staff the co... Read more
Coding Quizzer:
Infuse Flu Shot Coding With New RAI Manual Instructions For Section W
Don't miss capturing a flu vaccination.How would you code the following examples in item W... Read more
Quality Improvement:
Quality Indicators Ailing? Give Them A Coding Checkup
An ''F' in assessment and coding can translate into a failing survey record.The first step... Read more
Test Yourself
Question: A fall coded at J4a or J4b is a covariate for which QI/QM that surveyors use to ... Read more
Quality Assurance:
Double-Check Risk Adjustors For QIs/QMs
Take advantage of the wiggle room for factors beyond the facility's control.MDS coding is ... Read more
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Know The Covariates For Short-Stay Residents With Pressure Ulcers
If a resident has one of these risk factors, be sure you code it.... Read more
Risk Management:
Capture RUGable Home Visits, Discharge-Related Care
Get resident off on the right foot at home--and show that you did.Ensuring a resident's sa... Read more
Risk Management:
Think Thrice Before Manipulating ARDs To Avoid Triggering QIs/QMs
Find out why efforts to stay off the survey radar screen can backfire.Facilities that set ... Read more
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Connect The Dots To Detect Dehydration
Seemingly unrelated signs and symptoms can signal this serious condition.Functional Signs ... Read more
In The Spotlight:
Harness The MDS To Move Into Best -Practices Territory
Use this step-by-step plan to improve care one area at a time.To develop a reputation as a... Read more
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Keep Careful Records To Keep Influenza Under Control
  Early detection can help protect residents, limit costs.If influenza strikes your ... Read more
MDS & Billing News
Wondering what's happening with the MDS 3.0? The instrument appears to be headed toward a ... Read more
Reader Question:
Don't Take A Fall For Omitting Falls In Section J
Question: If we walk into a room and find a resident on the floor, and the person is too c... Read more
Medicare Payment:
Don't Let A Leave Of Absence Leave You Holding The Bag
Nail down the in's and out's of LOAs as a billing, MDS issue.When residents go on a leave ... Read more
What Do You Think?
Question: Does a leave of absence (LOA) for Medicare Part A-stay SNF patients create poten... Read more
Clinical Assessment:
Unmask This Health Bandit Before It Hurts Residents And Your Quality Outcomes
These multiple MDS items may clue you in to undetectable anemia.What do falls, cognitive d... Read more
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Look For RAP Patterns That May Signal Anemia
Anemia symptoms will trigger the following resident assessment protocols (RAPs):  Del... Read more
Medicare Billing:
Make Sure You're At Fault Before You Take The Default Rate
There's only one reason to dock your RUG payment.If you don't finish the MDS or transmit i... Read more
Coding Quizzer:
Keep 'Walking in Corridor' ADL Scores in Line
How would you code the following example for Section G (walk in corridor)?Mrs. Q. requires... Read more
MDS Accuracy:
Enlist DAVE To Stave Off Payment And Survey Woes
Target these audit hotspots now.DAVE may be gone, but its handiwork is in the hands of gov... Read more
MDS Compliance:
Target These Top 5 Discrepant Section G Items Uncovered By DAVE
G1b(A) - Transfers/Self-PerformanceG1a(A) - Bed Mobility/Self -PerformanceG1i(A) - Toilet ... Read more
In The Spotlight:
Catch MDS Inconsistencies Before They Slip Through The Cracks
An audit system is just the ticket to prevent compliance, care plan shortfalls.MDS items t... Read more
Test Yourself
How would your facility handle this scenario?The SNF sets the assessment reference date (A... Read more
MDS & Billing News
Do you know how to access the new quality indicator/measure reports? The reports are now a... Read more
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Raise The Bar On Your ADL Care Plans
Make sure your're covering these bases to promote optimal functional status.  ... Read more
Quality of Care:
Mop Up Incontinence Assessment, Coding Woes Before You Take A Survey Spill
Cover these bases under revised F315 guidelines.Urinary incontinence has moved into the ho... Read more
Case Study:
Pull Your Urinary Incontinence QIs Down The Flag Pole
Check out this facility's quality improvement approach.If you're looking for a surefire wa... Read more
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Know How Revised F315 Survey Guidance Defines Types Of Urinary Incontinence
Determine which type of incontinence your resident has.To care plan an incontinence proble... Read more
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Check For Meds That Can Cause Or Worsen Incontinence
Medication             &n... Read more
Quality Indicators:
Get Ready To Implement The New Set Of Quality Indicators/Measures
Learn what makes the QIs/QMs tick before the clock runs out. Surveyors may soon be arrivin... Read more
MDS Coding:
Stay In Tune With Residents Moving Up And Down The Mood Scale
The incidence-based depression QM looks at these key areas.Make sure to track and care pla... Read more
Resident Assessment:
Let Section 1 Be Your Pain Guide
Don't underestimate the pain associated with these conditions.Nurses who want to be good p... Read more
What Do YouThink? Find Out How And When To Code Pain Diagnoses
Question: Are there ICD-9-CM codes that differentiate between acute and chronic pain?Answe... Read more
MDS Accuracy:
Score 'O' Errors In Section O
CMS Webcast offers winning strategies for coding meds. If coding Section O seems like no b... Read more
Coding Quizzer:
Coding Section O
Use the Medication Administration Record below to code items O1 to O4.How would you code t... Read more
MDS Accuracy:
Wondering How To Code Multivitamins, TPN, Herbal Remedies, Skin Rx?
To code Section O, you have to know not only what to count but how to count it, as follows... Read more
MDS 7 Billing News
Gear up to implement the new ICD-9-CM codes on Oct. 1, 2005.  Here's what's coming do... Read more
Medicare Payment:
Prevent Assessment Reference Dates From Being Rendezvous With Payment Woes
Make ARDs work for - rather than against - your facility.There's more riding on your ARDs ... Read more
Coding Quizzer:
Coding Wounds That Don't Fit M1
How would you code the following example?Mr. Alaska has five open wounds as a result of fr... Read more
MDS Coding:
Watch Out For These Payment Drivers In June RAI Manual Update
Coding gets trickier with latest revisions.The June 15 RAI manual update may have clouded ... Read more
What Do You Think?
Question: Can different MDS assessments have overlapping assessment reference periods?Answ... Read more
RAI Compliance:
Don't Throw Standing MDS Requirements Out With Rescinded RAI Manual Update
Hint: Out of manual shouldn't mean out of mind if you want to remain in compliance with th... Read more
RAI Manual Update:
Key In On These Keepers In June RAI Manual Revision
Use this list to make sure you're covering the bases in the update. Check out the highligh... Read more
Case Study:
Dig Deep To Get To The Bottom Of A Fall
Taking the right steps in time can protect your residents and survey record.When a residen... Read more
Case Study:
Tap MDS, OSCAR, Cost Report Data To Root Out Hidden Fall Risks
Here's the surprising conclusion a QA team reached about a fall-related injury.To ferret o... Read more
Prospective Payment System:
Beware: PPS Rule Expands RUGs But Closes Assessment Windows
 The time is now to comment on the proposal's payment drain.Did you know? The Centers... Read more
MDS & Billing News
The OIG recently handed out kudos to nursing homes for doing a good job in meeting their M... Read more
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Here's What The Proposed 'RUG-53' Tree Would Look Like
Check out the proposed new payment branches.... Read more
RAI Compliance:
Hold The May 1 RAI Update-Or You'll Be Out Of Compliance
CMS to clarify the changes with new May 23 release. Out with the new and back to the old: ... Read more
Medicare Payment:
Slip On Your HIPPS And Risk RUG Burn
Keep your balance in the black with this essential information.No one can be right all the... Read more
Medicare Billing:
Develop Systems To Nail Down Assessment Type, RUGs
Here's how to keep your HIPPS in line.Communication between the MDS nurse and billing prov... Read more
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Check Out These Pain Scales For Residents With Dementia
Best practices call for use of an assessment tool geared toward residents' needs and abili... Read more
Assessment and Coding:
Take The Pain Out Of Assessing And Coding For Section J
Erase coding errors in 6 steps.Section J2 offers a window to residents' pain - one you can... Read more
Coding Quizzer:
Be Prepared To Code Section B5 (Delirium)
How would you code this case example in Section B5?Mrs. K is a 92-year-old widow of 30 yea... Read more
MDS Coding:
Know How To Code Sections J2 and J3 For Pain
Make sure to code pain sites, including pressure ulcer pain.... Read more
In The Spotlight:
Use This Best-Practice Approach To Avoid Being A Weight-Loss Leader
Keep weights in the healthy zone with trigger points for action.Poor scores on weight loss... Read more
Dietary Assessment:
Resident Dropping Pounds Or Not Eating Well?
These MDS items may hold the answers.The MDS can red-flag residents whose nutritional stat... Read more
MDS & Billing News
Is your facility coding diagnosis by the book as of April 1? The ICD-9-CM codes haven't ch... Read more
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Code The Right Assessment Indicator
This chart spells out code descriptors, billing requirements.... Read more
Medicare and Medicaid:
Keep Your RUGs Out Of A Rut
These 4 RUG profiles can dig a facility into a payment deficit.Keeping an eye on RUG patte... Read more
MDS Coding:
Undercoding Depression Can Cause Fiscal Blues
Compare the clinically complex RUGs for residents with and without depression (based ... Read more
RAI Compliance:
Master Latest Wave Of MDS Coding Changes For May 1 Implementation
Update affects ADLs, therapy, restorative, wound coding and more.If you feel as if you're ... Read more
RAI Manual Update:
CMS Tries To Take The Pressure Off For Coding Skin Conditions
RAI manual clarification aims to prevent coding redundancy.Question: What type of ulcers d... Read more
Coding Quizzer:
Section M1
How would you code the following example in Section M1 (ulcers)?Mrs. L has end-stage metas... Read more
Regulatory Compliance:
Nail Down Who Signs What, When On The MDS
RAI manual clarification provides key compliance instructions.Hot off the press:  Sta... Read more
MDS News:
New Section W To Capture Flu/Pneumonia Vaccinations
Here's what you need to know now.MDS section "W" will be asking a couple of the "W" questi... Read more
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Use This Tool To Get An 'A' In Attestation
CMS provides this example for dating and signing AA9.    ... Read more
Resident Assessment:
Assessing Cognitive Or Psychotic Sx? Round Up More Than The Usual Suspects
The resident's real problem may be easily correctable.If a resident has Alzheimer's, you m... Read more
Assessment Tip:
Don't Let Your Residents Be Light - Or Heavy - Weights
Color-coding scheme tips scales toward improved accuracy. Weighing patients can trip up y... Read more
Test Yourself:
Weigh In On Coding Section J1a
True or false? You don't code J1a on the MDS (weight gain or loss of three pounds or more ... Read more
Medicare Compliance:
Spare A Resident's Medicare Days And Strike Out In The Compliance Arena
Find out why this often good-faith effort is a bad compliance idea. Saving a resident's Me... Read more
MDS & Billing News To Use
The MDS 3.0 is moving along, although don't look for the instrument to be ready for prime ... Read more
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Get Your Info In A Row For Billing Medicare
Check out this form for improving billing accuracy.... Read more
Resident Assessment:
Don't Make Pressure Ulcers Appear Better - Or Worse - Than They Really Are
Get clinicians, surveyors, payers on the same page with wound severity.With tougher F314 g... Read more
Coding Quizzer:
Try Your Hand At Coding Range Of Motion In Section G4
How would you code these two examples in G4 (column A)?Example 1: Mr. O was admitted to th... Read more
Medicare Payment:
Keep Pressure Ulcers On Your Payment Radar Screen
Prevent residents with 2 decubs from slipping from a higher RUG.What you don't code can co... Read more
Coding Tip:
Use Site-Specific Pressure Ulcer Codes To Support Billing, Quality Assurance
Including specific ICD-9-CM codes for pressure ulcers in Section I3 of the MDS and on the ... Read more
Medicare Payment:
To Skill Or Not To Skill Residents For Restorative Nursing?
Experts shed some light on this controversial coverage debate.If a Medicare beneficiary do... Read more
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Does Your Pressure Ulcer Care Plan Address These Key Elements?
  Checklist:  Assessment and Reassessment of Pressure UlcersDoes your facility ... Read more
Restorative Nursing:
Know What Counts As Restorative For Coding Section P3
Use this checklist of requirements.To provide restorative nursing is one thing, but coding... Read more
In The Spotlight:
Facilities Use New Technology To Detect Hidden Pre-Ulcer Condition
Portable ultrasound scans offer latest wave in wound risk management.No one expects nurses... Read more
Risk Management:
Technology Holds Promise For Preventing Pressure Ulcers
But does it really work ... and will Medicare pay for it?Proof, pricing and payoff - that'... Read more
What Do You Think?:
Can You Skill A Resident For Psych Or Behaviorally Focused Care? The Answer Is Yes, But ...
Here's what you need to know. Question: When can SNFs skill residents for primarily psychi... Read more
Medical Review:
Two Cases Billed To Medicare For Behavior RUG - One Paid, The Other Not
MDS coding alone won't cut the mustard with medical reviewers.The MDS may be exactly the s... Read more
MDS & BILLING NEWS TO USE
Are you up on the latest CMS clarification for electronic MDS signatures? Nursing faciliti... Read more
Survey Management:
Code These Risks And Rx - Or Risk Getting Blamed
Picture this: A surveyor or DAVE reviewer asks to compare her assessment of a resident wit... Read more
Coding Quizzer:
Wound Dressings in Section M5
Do wound dressings have to be applied daily in order to code them in Section M5 on the MDS... Read more
Quality Assurance:
Keep Your Eye On The QI
Is that resident really low risk for a pressure ulcer?When a resident with a pressure ulce... Read more
Risk Management:
Sidestep This Common Pitfall In Pressure Ulcer Prevention
Hint: Don't let your guard down with 'low risk' residents."The squeaky wheel gets the grea... Read more
In The Spotlight:
Play By The Medicare Rules And Win Big For Resident Care
Find out how this SNF increased revenues by a half mil in one year.Implement prospective p... Read more
What Do You Think?
Question: Do Medicare rules ever allow you to delay skilled coverage for services beyond 3... Read more
MDS Coding:
Don't End Up High And Dry By Miscoding Signs
Follow CMS' Webcast tips to improve accuracy of Section J1c.Over code dehydration and you'... Read more
Diagnosis Coding:
Flush Out Inaccurate Dehydration Diagnoses In Section I3
Before you code, confirm a resident has true clinical dehydration.A little diagnosis and c... Read more
MDS & BILLING NEWS TO USE
Ready for a new inpatient universal billing form? It's not exactly a done deal, but the Na... Read more
Resident Assessment:
Revisit Wound Dx And Coding - Or Your Facility Will Be Nursing Survey Wounds Of Its Own
Follow this formula to heal non-pressure wounds and prevent F309 tags.An ulcer might "walk... Read more
Coding Quizzer:
Section G1 (Activities of Daily Living)
Check your bed mobility assessment.How would you code these two examples of bed mobility?E... Read more
DAVE Program:
Doctor Section I With The Right Diagnosis Coding Cures
7 ways to keep DAVE off your case.The "I's" have it as far as DAVE is concerned in winning... Read more
Drug Monitoring:
Be A Private Eye: Use The MDS To Flag Antipsychotic ADRs
Detect conditions that may really be drug-induced.What do Parkinson's symptoms, diabetes, ... Read more
In The Spotlight:
Kick The MDS Into High Gear For Short-Stay
Follow the beat of this SNF to pick up the pace of assessment and care.There's nothing so ... Read more
Legal Tip:
Your Nurse Practice Act Could Include A Troubling Surprise
Better double-check who's qualified to do what. Your facility could be in for legal woes i... Read more
Patient Satisfaction:
Care For People, Not Paper Or Processes
Free up your facility's most precious clinical commodity: time for patients.The best recip... Read more
Test Yourself:
Wound Assessment - Arterial Versus Venous Insufficiency Ulcers
New survey guidance provides key clues to assess the difference.Test your assessment prowe... Read more
MDS & BILLING NEWS TO USE
Beware: DAVE has lots of MDS integrity issues on the front and back burners for 2005. The ... Read more
Reader Questions
Don't Be Too Early Or Late With Noncoverage NoticesQuestion: Is there is a certain period ... Read more
Payment and Regulatory Compliance:
Keep Your RUGs Straight And Enjoy A Clean Compliance Slate
Jettison this dangerous idea about MDS accuracy. Don't be misled: MDS undercoding can be a... Read more
Survey Compliance:
When Residents Take Antipsychotics, Keep Your Eye On QI 19 And The MDS Driving It
Use these strategies to survey-proof your coding and documentation. The MDS tells surveyor... Read more
Coding Quizzer:
Be Forewarned When You Code B4
A quick assessment won't do the trick. If a resident seems to have severe cognitive impair... Read more
Drug Monitoring:
Is That Antipsychotic Med Really Helping? Check These MDS Sections Before Surveyors Do
Hint: Evaluate target behaviors in Section E4, but don't stop there. Let the MDS be your g... Read more
Medicare Payment:
Kick Your Medicare Skilled Coverage Determination And Documentation Skills Into High Gear
Cover the coverage triad and combat these 4 expensive myths. Myths about Medicare skilled ... Read more
What Do You Think?
Question: Do Medicare regulations ever allow a facility to delay skilled services beyond 3... Read more
Case Study:
Ready, Set, Audit: Ensure Your Skilled Nursing Documentation Makes The Grade For Part A Coverage
Top-notch documentation builds a solid case for the resident being skilled ... here's how ... Read more
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Check Out The Exclusions, Risk Adjustments For QI 19
Mark sure to code excluded psychiatric diagnoses conditions.... Read more
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Combine A Skilled Care Checklist And Narrative Notes Form
Here's an example of how to individualize documentation of skilled services.... Read more
MDS & BILLING NEWS TO USE
The Pressure Is On With Revised F314 Tag. The Centers for Medicare & Medicaid Services... Read more
Available Years:  2005  2004  2003