PDPM Coding Question – 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?

by | 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...

PDPM Coding Questions – If a resident has a BMI greater than 40 but the MD has not documented “morbid obesity”, can we enter the Z code for BMI in the MDS and receive the NTA point?

by | Mar 17, 2020 | Coding, ICD.10, MDS, PDPM, Q&A

Q: If a resident has a BMI greater than 40 but the MD has not documented “morbid obesity”, can we enter the Z code for BMI in the MDS and receive the NTA point?   A: Yes, but as stated in the ICD-10-CM Code Book: BMI codes should only be assigned when the...

PDPM Coding Questions – If the dietitian completed a malnutrition assessment and the score indicates “at risk for malnutrition”, is the assessment considered sufficient supportive documentation to code Malnutrition in Section I if the physician were to review and sign the assessment form?

by | Mar 17, 2020 | Coding, Documentation, MDS, Medicare, PDPM, Q&A

Q: If the dietitian completed a malnutrition assessment and the score indicates “at risk for malnutrition”, is the assessment considered sufficient supportive documentation to code Malnutrition in Section I if the physician were to review and sign the assessment form?...

PDPM Coding Questions – The physician documented dehydration on the discharge summary, however the resident does not qualify for any of the 3 items listed in the RAI manual in J1550. Should dehydration be coded on the MDS?

by | Mar 4, 2020 | Coding, MDS, Medicare, PDPM, Physicians, Q&A

Q: The physician documented dehydration on the discharge summary, however, the resident does not qualify for any of the 3 items listed in the RAI manual in J1550. Should dehydration be coded on the MDS?   A: The coding for dehydration is based on the presence of...

PDPM Coding Questions – If a physician diagnoses “sepsis” but no mention of septicemia, and blood cultures come back negative, can you still code “Septicemia” in I2100?

by | Feb 18, 2020 | MDS, Medicare, PDPM, Q&A, Quality Measure

Q: If a physician diagnoses “sepsis” but no mention of septicemia, and blood cultures come back negative, can you still code “Septicemia” in I2100?   A: When you search for septicemia in the ICD-10 coding guidelines, you are cross-referenced to see sepsis &...