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Q: If two different physicians visit a resident on the same day of the week, can you count that as two visits in MDS item P7, physician visits?

Julia's PPS Chat, January 7, 2004

Welcome back to our PPS chat!

You might remember that a few months ago we were chatting about the importance of counting correctly-that is, counting accurately for coding assessment information on the MDS.

We have another example of this counting principle in the following question and answer.

Q: If two different physicians visit a resident on the same day of the week, can you count that as two visits in MDS item P7, physician visits?

A: Let's review the Revised Resident Assessment Instrument (RAI) User's Manual for an explanation on coding this item. The manual states on p. 3-204 that the intent of this item is "to record the number of days during the last 14-day period a physician has examined the resident (or since admission if less than 14 days ago)."

When responding to this item, first consider the type of information requested. Note that you should code the number of days, not the number of visits.

Also be aware that the 14-day period does not include any time prior to admission. Unlike other MDS items that can include a hospital lookback period, this item specifically states that only the time since admission should be considered.

Therefore, count back 14 days from your assessment reference date-with your assessment reference date being the 14th day-and add together the number of days a physician saw your resident.

To address your question, if two visits occurred on the same day, you should count this as only one visit.

Always be sure to accurately count the number of physician visits as this item can influence your PPS reimbursement rate.

When coding this item on the MDS, be sure to distinguish between days and visits. Maybe this information can help you to keep your New Year's resolution of accurately assessing your resident and completing the MDS correctly.

Our next PPS chat will talk about estimation of therapy days and minutes.

Until then—