Long-Term Care

Coding concurrent therapy under the MDS 3.0

MDS 3.0 Insider, December 28, 2009

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Under the MDS 3.0, therapy services are now located in Section O, Special Treatments and Procedures. The MDS 3.0 will allow facilities to capture minutes of concurrent therapy, which is the practice of one therapist treating multiple patients at the same time while the patients are performing different activities. However, concurrent therapy minutes will be calculated differently under the MDS 3.0 and RUG-IV than they are currently.
 
Under the MDS 2.0 and RUG-III, concurrent therapy minutes are counted as one-on-one therapy minutes. This means that if you provide 90 minutes of therapy to a group of three residents who are all doing different exercises, you can capture the entire 90 minutes for each resident on the MDS.
 
The MDS 3.0 and RUG-IV will require therapists to use their professional judgment to divide concurrent therapy minutes among the residents receiving the service. The following are excerpts from the Resident Assessment Instrument (RAI) User’s Manual describing coding concurrent therapy minutes on the MDS 3.0 and defining concurrent therapy under Medicare Part A and Part B:
 
Concurrent therapy coding instructions:
“Concurrent minutes—Enter the total number of minutes of therapy that was provided on a concurrent basis in the last 7 days. Enter 0 if none were provided. Concurrent therapy is defined as the treatment of 2 residents at the same time, when the residents are performing two different activities, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant for Medicare Part A. For Part B, residents may not be treated concurrently: a therapist may treat one resident at a time, and the minutes during the day when the resident is treated individually are added, even if the therapist provides that treatment intermittently (first to one resident and then to another).”
 
Source: MDS 3.0 RAI User’s Manual, Section O, Special Treatments and Procedures, p. O-14
 
Definition of concurrent therapy:
“Medicare Part A: The treatment of 2 residents at the same time, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant.
Medicare Part B: The treatment of two or more residents at the same time is documented as group treatment. Regardless of whether those residents are doing the same or different activities.”
 
Source: MDS 3.0 RAI User’s Manual, Section O, Special Treatments and Procedures, p. O-18.
 



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