by Proactive Medical Review | May 21, 2020 | blog, Education
Q: What is the #1 ICD.10 coding error that you find in your audits? A: Answer: The coding error seen most often is using acute conditions/diagnoses. The RAI Manual states while certain conditions represent acute diagnoses, SNFs should not use acute diagnosis...
by Proactive Medical Review | May 21, 2020 | blog, COVID-19, Education
Q: Should presumptive positive COVID-19 test results be coded as confirmed? A: Yes, Presumptive positive COVID-19 test results should be coded as confirmed. A presumptive positive test result means an individual has tested positive for the virus at a local or...
by Proactive Medical Review | May 12, 2020 | blog, Education
Q: I have a resident who was discharged from Medicare A services, but then had a renewed skilled need and will receive skilled speech therapy services. How do I code section GG if we are not addressing ADL needs (no PT or OT services)? A: All column 1 –...
by Proactive Medical Review | May 12, 2020 | blog, Education
Q: Can you use a “Z” code as a primary diagnosis under PDPM and map to a Clinical Category? A: The ICD-10-CM Coding Guidelines state that some Z-codes can be primary. There are many Z-codes that would not be appropriate to use as primary diagnoses...
by Proactive Medical Review | May 6, 2020 | blog, CMS, Education, PDPM
Q: Now that CMS approved OT, PT, and SLPs for telehealth service delivery, can we start utilizing this distant service option for treatment delivery with appropriate patients? A: New guidance issued by CMS issued on April 30th acknowledges OT, PT, SLP...
by Proactive Medical Review | Apr 29, 2020 | blog, Education
Q: If the resident continues to have a dry cough after hospitalization, do I still use the RO5 for cough–he had one positive test for COVID-19 and 2 negatives? A: You should only code the signs and symptoms (i.e. R05 cough) if the patient has s/s...
