MDS Alert
MDS & BILLING NEWS
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Good news for Part B rehab patients: The therapy exceptions process will remain in place through 2007. President Bush has signed into law The Tax Relief and Health Care Act of 2006, which includes a provision extending the exceptions to limits on Medicare outpatient rehabilitation therapy for patients requiring more intensive rehab. Thus, the "existing exceptions process will remain in place for another year," says Barbara Gay, a spokesperson for the American Association of Homes & Services for the Aging. The exceptions process, which CMS implemented in March 2006, has worked well, Gay tells Eli. She believes it "seems to meet the congressional intent of addressing over utilization while also ensuring that beneficiaries who have had strokes and hip replacements, etc., get the rehabilitation therapy they need."
Check out this transmittal: Centers for Medicare & Medicaid transmittal 1145, released on Dec. 29, 2006, puts an end to the manual exceptions process. Now, all exceptions are automatic. This makes the exceptions process a little smoother for both CMS and providers. But be certain you continue to keep thorough supporting documentation for those patients who exceed the caps. You'll need to be able to demonstrate that they have good reason to need additional therapy. (Read the transmittal at www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf.)
Does your print version of the RAI manual contain this inaccuracy? CMS has become aware that "several commercial publishers have printed RAI User's Manuals for MDS Version 2.0 with misinformation regarding: Section G, chapter 3, page 83," the agency states in a recent notice. CMS says the incorrect RAI manual version appears to include draft May 2005 revisions rescinded shortly after their release. The agency subsequently issued a revised June 2005 version of the update.
The real deal: For the official RAI User's Manual for MDS 2.0, go to www.cms.hhs.gov/NursingHomeQualityInits/20_NHQIMDS20.asp.
MDS Alert
- REIMBURSEMENT:
Make Sure Therapy, Restorative Minutes In Section P Add Up To Fair Payment
Here's how to keep the RUGs on the money. Time flies when you're busy. But [...] - COMPLIANCE:
Before You Code At P3: Does Your Restorative Program Meet These Key Criteria?
If not, you may be in for payment recoupments. Providing restorative nursing is one thing, [...] - SPECIAL FOCUS:
PRESSURE ULCER STAGING & CODING ~ 3-Step System Eases The Pressure Of Staging, Coding Pressure Ulcers Correctly
How to navigate the standard of care and MDS requirements. Over- or understaging pressure ulcers [...] - RAI COMPLIANCE:
Know The Consequences Of Understaging Pressure Ulcers
Here are the F tag and RUG realities. What you code on the MDS is [...] - SURVEY MANAGEMENT:
Don't Let A Stage 1 Pressure Ulcer With Visible Deep Tissue Damage Turn Into A Damaging Survey
Make this smart move when dealing with a deceptive decub. Envision this: A post-op patient [...] - QUALITY OF CARE:
Assess, Document 'The Rest Of The Story' For Residents' Behavioral Symptoms
Recognize the limits of Section E4 as the be-all and end-all. When evaluating residents' behaviors, [...] - TEST YOURSELF:
Analyze This: A Resident's Potential RUG Placement
Directions: Read the following case example, which includes enough information to answer these questions:
1. [...] - QUALITY MEASURES:
Boost Your Pneumococcal Vaccination Rates, QM Scores
Take your best shot at immunizing eligible residents, coding W3. To protect your residents from [...] - INFECTION CONTROL:
Immunocompromised Residents Need A Booster Dose Of Pneumococcal Vaccine
Watch out for residents with these conditions. Here's one list you'll want to have close [...] - CLIP & SAVE:
The Draft MDS 3.0 Eliminates Reverse Staging, Captures Pressure Ulcers Present At Admission
See what the future may hold for coding decubitus ulcers. - MDS & BILLING NEWS
Good news for Part B rehab patients: The therapy exceptions process will remain in place [...] - CLIP N SAVE:
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