PDPM Coding Question – How should situations, in which the 3-day qualifying hospital stay normally required for a covered Medicare admission to the SNF is waived due to the national emergency, be reported on the UB04 claim form?

Q: How should situations, in which the 3-day qualifying hospital stay normally required for a covered Medicare admission to the SNF is waived due to the national emergency, be reported on the UB04 claim form?   A: Providers that receive beneficiaries without a...

PDPM Coding Questions – If the dietitian completed a malnutrition assessment and the score indicates “at risk for malnutrition”, is the assessment considered sufficient supportive documentation to code Malnutrition in Section I if the physician were to review and sign the assessment form?

Q: If the dietitian completed a malnutrition assessment and the score indicates “at risk for malnutrition”, is the assessment considered sufficient supportive documentation to code Malnutrition in Section I if the physician were to review and sign the assessment form?...

PDPM Coding Questions – The physician documented dehydration on the discharge summary, however the resident does not qualify for any of the 3 items listed in the RAI manual in J1550. Should dehydration be coded on the MDS?

Q: The physician documented dehydration on the discharge summary, however, the resident does not qualify for any of the 3 items listed in the RAI manual in J1550. Should dehydration be coded on the MDS?   A: The coding for dehydration is based on the presence of...

PDPM Coding Questions – If a physician diagnoses “sepsis” but no mention of septicemia, and blood cultures come back negative, can you still code “Septicemia” in I2100?

Q: If a physician diagnoses “sepsis” but no mention of septicemia, and blood cultures come back negative, can you still code “Septicemia” in I2100?   A: When you search for septicemia in the ICD-10 coding guidelines, you are cross-referenced to see sepsis &...

PDPM Coding Questions – Can you continue to skill with a resolved diagnosis? We have been discharging resident from skilled services once the active diagnosis is resolved example: UTI, E. coli, and pneumonia. Are we correctly doing this?

Q: Can you continue to skill with a resolved diagnosis? We have been discharging resident from skilled services once the active diagnosis is resolved example: UTI, E. coli, and pneumonia. Are we correctly doing this?   A: Providers should assess the resident’s...

PDPM Coding Questions – If a resident is cut from skilled services but a new skilled need arises during the interrupted stay window, would the facility be allowed to re-skill the resident?

Q: If a resident is cut from skilled services but a new skilled need arises during the interrupted stay window, would the facility be allowed to re-skill the resident?   A: The Medicare Benefit Policy Manual, Chapter 8 states that “Another qualifying hospital...