Long-Term Care

Coding O0400, Therapies

MDS 3.0 Insider, November 14, 2011

Want to receive articles like this one in your inbox? Subscribe to MDS 3.0 Insider!

Version 1.07 of the RAI User’s Manual contains many changes that went into effect October 1. Keeping track of all the changes is enough to make your head spin. So let’s take it one step at a time and look at some of the new coding instructions for Section O0400 (future issues will cover the remaining changes to Section O0400):

  • Co-treatment for Part A: When two clinicians, each from a different discipline, treat one resident at the same time (with different treatments), both disciplines code the treatment session in full. All policies regarding mode, modalities and student supervision must be followed. The decision to co-treat should be made on a case-by-case basis and the need for co-treatment should be well documented for each patient.
  • Co-treatment for Part B: Therapists, or therapy assistants, working together as a “team” to treat one or more patients cannot each bill separately for the same or different service provided at the same time to the same patient. CPT codes are used for billing the services of one therapist or therapy assistant. The therapist cannot bill for his/her services and those of another therapist or a therapy assistant, when both provide the same or different services, at the same time, to the same patient(s). Where a physical therapist (PT) and occupational therapist (OT) both provide services to one patient at the same time, only one therapist can bill for the entire service or the PT and OT can divide the service units. For example, a PT and an OT work together for 30 minutes with one patient on transfer activities. The PT and OT could each bill one unit of 97530. Alternatively, the two units of 97530 could be billed by either the PT or the OT, but not both. Similarly, if two therapy assistants provide services to the same patient at the same time, only the service of one therapy assistant can be billed by the supervising therapist or the service units can be split between the two therapy assistants and billed by the supervising therapist(s).

For more in-depth guidance on MDS 3.0 coding and processes, attend our all-new MDS 3.0 Boot Camp: Beyond the Basics. This course will help you harness the potential of the MDS 3.0 to deliver outcomes that will grow your business. Your interdisciplinary team will learn to improve processes, enhance communication, and execute clinical pathways to achieve premium person-centered care, quality outcomes, and accurate payment.

This advanced Boot Camp goes beyond filling out the MDS 3.0 form-it will instill the culture change your facility needs to thrive in a time of heightened compliance scrutiny, sicker residents, and shrinking revenue. Attend the only MDS 3.0 program that instructs on the most up-to-date MDS 3.0 and SNF PPS information.

Attend a class and get CPRA certified!
The CPRA credential conferred by HCPro is the new standard for MDS certification in long-term care. The CPRA exam-available in Fall 2011-is the most accurate measure of interdisciplinary competence in resident assessment with a special focus on converting clinical theory into practice.

How do I get my CPRA certification?
You will take an online certification exam at your convenience. The exam is not administered at the live Boot Camp location. While you do not need to attend the Boot Camp to qualify for certification, the Boot Camp teaches all of the material covered on the exam and is an excellent way to ensure that you're fully prepared for both the exam and your work. For complete details, visit www.cpraonline.com.

For more information about our MDS 3.0 Boot Camp: Beyond the Basics, call our customer service team at 800/780-0584.

Want to receive articles like this one in your inbox? Subscribe to MDS 3.0 Insider!

Most Popular