Ask Proactive – Our facility is triggering the UTI QM, and we have identified that many of these are the result of the hospital diagnosing a UTI that does not meet our infection criteria. Do we have to code those on the MDS if they occur during the look-back period?

by | Sep 18, 2024 | Coding, Q&A, Quality Measure, RAI Manual, Reimbursement

Q: Our facility is triggering the UTI QM, and we have identified that many of these are the result of the hospital diagnosing a UTI that does not meet our infection criteria. Do we have to code those on the MDS if they occur during the look-back period?    ...

Ask Proactive – My biller is requesting a HIPPS code for a Medicare resident who admitted to our SNF and then transferred to an assisted living facility on the same day. I didn’t think we could bill for the day of discharge. Please clarify.

by | Sep 4, 2024 | Coding, Medicare, Q&A, Reimbursement

Q: My biller is requesting a HIPPS code for a Medicare resident who admitted to our SNF and then transferred to an assisted living facility on the same day. I didn’t think we could bill for the day of discharge. Please clarify.     A: Generally, the day of...

Ask Proactive – A new resident was admitted to our facility with an order for Mirtazapine 15mg every evening. There is no information in the admission paperwork regarding its use and the admitting nurse entered the order “for antidepressant.” Should N0415C2: High-Risk Drug Classes: Indication be coded “yes” or “no”?

by | Aug 27, 2024 | Q&A

Q: A new resident was admitted to our facility with an order for Mirtazapine 15mg every evening. There is no information in the admission paperwork regarding its use and the admitting nurse entered the order “for antidepressant.” Should N0415C2: High-Risk Drug...