by Proactive LTC Consulting | Apr 3, 2024 | ICD.10, Nursing, PDPM, Q&A, Reimbursement
Q: I had a resident admitted to our SNF under skilled care who has been diagnosed with HIV/AIDS, but the NTA points are not generating in the HIPPS code. Can you please explain why this is happening and what corrective action should be taken to ensure reimbursement is... by Proactive LTC Consulting | Feb 6, 2024 | Blog, Compliance, Documentation, ICD.10, MDS, Nursing, PDPM, Reimbursement, SNF
PDPM coding and reimbursement success relies significantly on ICD-10 coding accuracy. In particular, the impact of ICD.10 coding on the clinical category, SLP, Nursing, and NTA comorbid diagnoses cannot be overstated; Medicare reimbursement for SNF services depends on... by Proactive LTC Consulting | Jan 31, 2024 | Blog, Depression, MDS, Nursing, Quality Measure, Reimbursement
The Minimum Data Set (MDS) plays a crucial role in influencing facility reimbursement, quality measures, and overall care quality. The accuracy of MDS coding is paramount, relying heavily on precise assessments and interviews. Accuracy in assessing and screening for... by Proactive LTC Consulting | Dec 19, 2023 | Blog, MDS, Quality Measure, Reimbursement, SNF
During the December SNF Open Door Forum call, CMS announced their plan to release the MDS 1.19.1, which will be effective October 1, 2024. CMS has indicated the revisions will be minor and impact primarily the following 3 areas of the MDS: Section GG: Self-care and... by Proactive LTC Consulting | Oct 25, 2023 | Blog, CASPER, MDS, Quality, Quality Measure, Reimbursement
Earlier this year CMS transitioned from QIES to IQIES for MDS submission and CASPER reporting access. This transition left some MDS coordinators confused about how to access reports that were previously made available through QIES. Available report types for each user... by Proactive LTC Consulting | Aug 23, 2023 | Blog, ICD.10, Medicare, PDPM, Reimbursement
PDPM has been in place for nearly four years, and with it came the shift from payment based on resource utilization to payment driven by patient characteristics and service provision. PDPM presents with many nuances and complexities that open the door to sinking...