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Issue 12, December 1, 2007 - VIEW THE FULL ISSUE

• Learn how the CPS can help your interdisciplinary team

  Editor's note: This article is the first in a two-part series about the CPS. Part two will examine...

• CMS offers insights for coding MDS Sections P and T

  Scenario: A therapist provides a physical therapy service such as electrical stimulation (E-Stim...

• Long-awaited MDS 3.0 rollout information trickles in

  Nursing homes have been waiting for information about the next version of the MDS for several...

Issue 11, November 1, 2007 - VIEW THE FULL ISSUE

• Changing the ARD of a PPS assessment

  The assessment reference date (ARD) is the last day-the common end point-of every MDS item's...

• Leave of absence past midnight means consolidated billing doesn't apply

  CMS has established that certain events trigger the end of a Medicare beneficiary's status as a...

• PPS Q&A

  The QIES Technical Support Office, which supports the submission and use of MDS data, recently...

Issue 10, October 1, 2007 - VIEW THE FULL ISSUE

• New ICD-9-CM codes: Key changes could affect your diagnosis coding

  Editor's note: Part one of this two-part series examined processes that need to be put in place to...

• Physical restraints: Learn what surveyors will evaluate

  In August, CMS held a series of Webcasts, "Physical Restraints in Nursing Homes: The Exception Not...

• Improve the coding accuracy of MDS item P4

  The two incarnations of the Data Assessment and VErification project (i.e., DAVE 1 and DAVE 2) have...

• Case study: What your restraint QM can-and can't-do

  The quality indicator/quality measure (QI/QM) reports that derive from MDS assessment data give a...

• PPS Q&A

  The QIES Technical Support Office, which supports the submission and use of MDS data, recently...

Issue 9, September 1, 2007 - VIEW THE FULL ISSUE

• Use new F-tag #323 guidance to fine-tune your accidents and supervision processes

  The new guidance combines F-tag #323 (accidents) and F-tag #324 (supervision) into one revised...

• ICD-9 update: Take steps to improve your coding accuracy

  Editor's note: Part one of this two-part series examines processes that need to be put in place to...

• OIG targets Medicare Part A rehab claims for audits and recoupment of reimbursement

  The Office of Inspector General (OIG) examined 100 sampled Medicare Part A claims from the skilled...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...

Issue 8, August 1, 2007 - VIEW THE FULL ISSUE

• CMS to SNFs: You've got default billing all wrong

  You know the general rule: If you miss an MDS assessment, you must bill the default rate. However...

• Demo projects abound at Open Door Forum

  While some MDS coordinators patiently wait for the MDS Version 3.0, others wonder whether a new...

• Use PPS schedule for MSP residents who qualify as Part A

  Medicare as a Second Payer (MSP) is primarily dealt with by billing and admissions departments in...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...

Issue 7, July 1, 2007 - VIEW THE FULL ISSUE

• Breaking down ADL coding

  Why do nursing homes continue to struggle with coding accuracy in MDS item G1, activities of daily...

• SCSAs: Learn how to get them 'just right'

  In the popular fairytale Goldilocks and the Three Bears, Goldilocks was seeking balance at the...

• Billing default for missed PPS assessments under fire

  As if there weren't enough MDS auditing tools out there, the government introduced a new one this...

• PPS Q&A

  The QIES Technical Support Office, which supports the submission and use of MDS data, recently...

Issue 6, June 1, 2007 - VIEW THE FULL ISSUE

• Surveyors showing up early?

  Some nursing home professionals across the country have recently been surprised by state surveyors...

• How the RUG-III system works with index maximizing

  Understanding the nuts and bolts of how facilities get paid under Medicare Part A SNF PPS is...

• Hone assessment skills to capture respiratory therapy on the MDS

  MDS coordinators often fail to code respiratory therapy services in MDS item P1bd, respiratory...

• PPS Q&A

  The QIES Technical Support Office recently posted an MDS test on its Web site. Test your knowledge...

Issue 5, May 1, 2007 - VIEW THE FULL ISSUE

• MDS 3.0 resident self-report items

  CMS has yet to set an implementation date for the MDS Version 3.0, noted agency officials during...

• Part A therapy requirements: Look to your payment source for answers

  In late March, CMS rescinded Transmittal 65, which would have applied some of the current Medi-care...

• New surveyor guidance slated for summer

  CMS has backpedaled on its earlier promise that there would be no more F-tags in fiscal year 2007...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...

Issue 4, April 1, 2007 - VIEW THE FULL ISSUE

• Changes to RAI User's Manual update fall short of expectations

  The next update to the RAI User's Manual was expected to roar in like a lion with some significant...

• Not all chemotherapy is excluded under consolidated billing

  Consolidated billing is simple enough in theory. Basically, the consolidated billing provision...

• Learn to calculate an ADL index score

  For most MDS coordinators, it's a no-brainer that the activities of daily living (ADL) affect the...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...

Issue 3, March 1, 2007 - VIEW THE FULL ISSUE

• Part A eligibility: CMS clarifies limits on qualifying hospital stay

  One of the so-called "technical" benefit eligibility criteria for Medicare Part A skilled nursing...

• Benefits exhaust and no-pay bills: Clinical team plays key role

  In April 2006, CMS issued Transmittal 930 (CR 4292) to establish a new process for submitting...

• Compliance with medication regulations requires a holistic review

  New surveyor protocols and guidance for unnecessary medications and pharmacy services took effect...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...

Issue 2, February 1, 2007 - VIEW THE FULL ISSUE

• Section M: Coding boggy skin vs. ecrotic eschar or slough

  A common question that MDS coordinators have about coding MDS item M1, ulcers, involves at what...

• Prepare for additional pressures on the MDS/PPS process in 2007

  Predicting the path of the MDS/PPS process isn't an exact science. CMS recently laid out its basic...

• 2007 to-do list: Take a stand with the administrative team

  There is overwhelming evidence of the core role the MDS plays in both the provision of resident...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...

Issue 1, January 1, 2007 - VIEW THE FULL ISSUE

• Restorative nursing and Part A

  Editor's note: This is part two of a two-part series. Last month's PPSA helped you fine-tune your...

• Are you cutting MDS coding corners?

  MDS coordinators today are struggling to balance increasingly nu-anced MDS coding requirements with...

• RAI process plays key role in activities compliance: Identifying crucial MDS

  MDS coordinators may find themselves playing a new role under F-Tag #248, Activities. Not only are...

• PPS Q&A

  Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-C, founding chair...