by Proactive Medical Review | Nov 24, 2020 | blog, Compliance, Physicians
The Department of Health and Human Services (HHS) and The Centers for Medicare and Medicaid Services (CMS) published two final rules last week, targeting the reduction of regulatory barriers to care coordination and increased flexibility for provider participation in...
by Proactive Medical Review | Nov 23, 2020 | COVID-19, PDPM Coding Questions
Q: Do we have to place new admissions in transmission-based precautions for 14 days after admission if we have a negative COVID-19 test at the time of admission? A: Yes, Per the CDC, new admissions should be placed in a single-person room or in a separate...
by Proactive Medical Review | Nov 18, 2020 | blog, Compliance, COVID-19, Medicare
As most providers are aware, the Centers for Medicare & Medicaid Services (CMS) suspended most Medicare fee-for-service medical reviews because of the COVID-19 pandemic on March 30, 2020. This included pre-payment medical reviews conducted by Medicare...
by Proactive Medical Review | Nov 17, 2020 | COVID-19, PDPM Coding Questions
Q: What MDS assessments need to be completed when newly skilling a current resident who develops COVID? Is a Significant Change required? A: Presuming skilled care requirements outlined in Chapter 8 of the Medicare Benefit Policy Manual have been met, a PPS...
by Proactive Medical Review | Nov 12, 2020 | COVID-19, PDPM Coding Questions
Q: Can we code morbid obesity for resident with Dx on DC Summary but BMI is not 40 or above? A: You can assign the E66 morbid obesity code if it is specifically documented by the provider & some sort of intervention/treatment due to obesity (i.e. reduced...
