What does RUG-IV mean for your facility?
Billing Alert for Long-Term Care, July 1, 2009
CMS released its proposed rule for fiscal year (FY) 2010 payment updates for SNFs May 1. Included in the rule is a proposal to implement a new case-mix classification model, known as Resource Utilization Group, Version Four (RUG-IV), in tandem with the MDS 3.0 October 1, 2010, which marks the beginning of FY 2011. Many of the changes incorporated into RUG-IV are evident in the updated MDS 3.0 Draft Item Set, which CMS released May 7.
Medicare uses a case-mix classification system to assign a nursing home resident to a RUG category based on his or her medical conditions and the resources needed to provide care. Each RUG category is tied to a Medicare payment rate.
Based on results from the Staff Time and Resource Intensity Verification project, CMS believes that the currently used model, RUG-III, is no longer an effective way to determine the resource time required to care for certain conditions.
- Complications from immobility by body system
- OB services: Coding inside and outside of the package
- Differentiate between types of wound debridement
- What does case-mix index mean to you?
- Don’t forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Pneumonia with a negative chest x-ray: Clinical diagnoses, physician documentation, and coding guidelines
- ICD-10 tip: Coding for infectious and parasitic diseases
- ICD-10-CM coma, stroke codes require more specific documentation
- Initiative launched to prevent physician, medical trainee suicides
- Stress Management
- Q/A: Coding for blood glucose checks
- How surviving a disaster changes the disaster plan
- HCPro's White Papers on the ANCC Magnet Recognition Program®: Collecting evidence for the written documentation
- Gap analysis: Three big issues
- Fetal non-stress tests represent important part of maternal and fetal health
- Don't let improper discharge disposition codes fly under the radar at your facility
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Code arthroscopic knee procedures using G0289
- CMS launches new online tool to make Quality Payment Program easier for clinicians