Do I have to restart the Medicare physician certification process when a resident qualifies for an interrupted stay?



The requirements for physician certifications and recertifications for the SNF PPS stay did not change with the implementation of PDPM. The facility should continue existing physician certifications where left off when the resident readmits to the SNF within the interruption window to resume skilled care.  The facility would only restart the physician certification and recertification process if the resident readmits after the interruption window and resumes skilled care within a new Medicare Part A stay.

Blog by Jessica Cairns, RN, RAC-CT, CMAC, Proactive Medical Review

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