by Proactive LTC Consulting | Oct 19, 2020 | Blog, Coding, Compliance, Documentation, MDS, Medical Review, Medicare, PDPM, Reimbursement
Has nursing documentation and internal auditing suffered due to COVID-19 prevention or outbreak efforts? Many facilities have had to prioritize staff and resources in order to meet the challenge of the public health emergency and the many additional responsibilities... by Proactive LTC Consulting | Sep 23, 2020 | Audits, Blog, Coding, MDS, Medical Review, Medicare, PDPM
As we began discussing in part 1 of this article last week, the accuracy of coding, documentation and data monitoring is vital as we prepare for the inevitable start of PDPM medical review audit activity. Provider data outliers will trigger audits, and any coding... by Proactive LTC Consulting | Sep 2, 2020 | Blog, COVID-19, Medicare
Q: Should PRF payments offset expenses on the Medicare cost report? A: No, providers should not adjust the expenses on the Medicare cost report based on PRF payments received. However, providers must adhere to HRSA’s guidance regarding appropriate uses of PRF... by Proactive LTC Consulting | Aug 4, 2020 | Blog, Medicare, PDPM, Q&A
Q: A resident had a UTI in the hospital but their antibiotics were finished before admitting to the facility. The DC Summary notes “UTI-Resolved”. Should UTI be coded? A: Yes, UTI must be coded in I2300 if occurred in the last 30 days. The RAI Manual (page... by Proactive LTC Consulting | Jul 28, 2020 | Blog, Medicare, PDPM, Q&A
Q: Do I have to restart the Medicare physician certification process when a resident qualifies for an interrupted stay? A: The requirements for physician certifications and recertifications for the SNF PPS stay did not change with the implementation of PDPM.... by Proactive LTC Consulting | Mar 18, 2020 | Medicare, PDPM, Q&A, Regulatory, Reimbursement, SNF
Q: How should situations, in which the 3-day qualifying hospital stay normally required for a covered Medicare admission to the SNF is waived due to the national emergency, be reported on the UB04 claim form? A: Providers that receive beneficiaries without a...