Ask Proactive – We have a resident who we are skilling related to a recent femur fracture. The principal diagnosis is S72.22XD, which maps to the Non-Surgical Orthopedic/Musculoskeletal Clinical Category, but it states “May be Eligible for One of the Two Orthopedic Surgery Categories”. How do we determine if it is eligible for one of the Orthopedic Surgery categories?

by | Mar 22, 2023 | Coding, ICD.10, MDS, PDPM, Q&A

Q: We have a resident who we are skilling related to a recent femur fracture. The principal diagnosis is S72.22XD, which maps to the Non-Surgical Orthopedic/Musculoskeletal Clinical Category, but it states “May be Eligible for One of the Two Orthopedic Surgery...

Ask Proactive – For the Quality Measure “Percent of Residents Who Newly Received an Antipsychotic Medication (SS),” is the initial assessment used in the calculation always an Admission or 5-Day?

by | Mar 15, 2023 | Antipsychotics/Psychotropics, Q&A

Q: For the Quality Measure “Percent of Residents Who Newly Received an Antipsychotic Medication (SS),” is the initial assessment used in the calculation always an Admission or 5-Day?   A: For this measure, the initial assessment is the first assessment completed...

Ask Proactive – We have a resident on Enhanced Barrier Precautions who will be staying at our facility long term. Are there criteria for discontinuing these precautions at some point?

by | Mar 6, 2023 | Infection, Nursing, Q&A

Q: We have a resident on Enhanced Barrier Precautions who will be staying at our facility long-term. Are there criteria for discontinuing these precautions at some point?   A: It depends on why the Enhanced Barrier Precautions (EBP) were implemented. For...

Ask Proactive – We have a physician who has requested that all patients be seen in her office rather than on-site at the facility. Will this satisfy the physician visit requirements?

by | Feb 23, 2023 | Compliance, Physicians, Q&A, Regulatory

Q: We have a physician who has requested that all patients be seen in her office rather than on-site at the facility. Will this satisfy the physician visit requirements?   A: The regulations do not specifically address a location requirement; however, according...

Ask Proactive – We have a patient with a stage IV pressure injury to the ankle that is being treated with a wound vac, which is changed 3x/week. Does this meet the criteria for skilled coverage under Medicare Part A in the SNF?

by | Feb 21, 2023 | Nursing, Pressure Ulcers, Q&A, Reimbursement

Q: We have a patient with a stage IV pressure injury to the ankle that is being treated with a wound vac, which is changed 3x/week. Does this meet the criteria for skilled coverage under Medicare Part A in the SNF?   A: The Medicare Benefit Manual Chapter 8...