by Proactive LTC Consulting | Oct 4, 2022 | Coding, ICD.10, Q&A
Q: I’ve noticed when reviewing resident diagnoses for MDS Section I that several of the diagnoses are suddenly showing an error message. How do I correct this? A: CMS has revised several ICD-10 codes for the 2023 fiscal year. These codes became effective October 1,... by Proactive LTC Consulting | Aug 17, 2022 | ICD.10, Q&A
Q: We have a claim denial from a commercial insurance plan that references their policy related to Excludes 1 Notes based on the ICD10 Official Guidelines for Coding & Reporting. OT and PT used codes R26.2 (difficulty in walking) and R26.81 (unsteadiness on feet)... by Proactive LTC Consulting | Aug 3, 2022 | Blog, CMS, ICD.10, PDPM
On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY)... by Proactive LTC Consulting | Jan 26, 2022 | Blog, ICD.10, PDPM
Since the inception of PDPM, selecting the Primary Diagnosis has been a challenge for MDS/RAI coordinators. Under PDPM, the diagnosis coded on the 5-day/Initial Minimum Data Set (MDS) in section I0020B largely determines reimbursement for the entire Medicare stay... by Proactive LTC Consulting | Jul 7, 2021 | Audits, Blog, Coding, Compliance, ICD.10, MDS, Reimbursement
Even though SNFs have collectively seen higher reimbursement rates under the Patient-Driven Payment Model compared to the previous RUG IV payment model, data shows that there is still room for improvement for most facilities in terms of ensuring accurate revenue under... by Proactive LTC Consulting | Jun 30, 2021 | Coding, ICD.10, Q&A
Q: How do I appropriately code a periprosthetic fracture? Should I use an M or S ICD-10 code? A: Fractures result from trauma or injury or a pathological condition. With a periprosthetic fracture, two ICD-10 codes would be utilized. One code would include the...