Ask Proactive – I know the PHE is set to expire in July. As we continue to admit new patients using the SNF waivers, what will happen if the PHE ends during the patient’s benefit period?

Q: I know the PHE is set to expire in July. As we continue to admit new patients using the SNF waivers, what will happen if the PHE ends during the patient’s benefit period?   A: Effective April 21, 2021, HHS Secretary extended the PHE, the new expiration date...

Ask Proactive – Is this a Fall with Major Injury? A resident had an unwitnessed fall and self-reported that she hit her head. No injuries or concerns were noted upon post-fall evaluations. Three days later, the resident was transferred to the hospital due to chest pain and non-reactive pupils. Diagnostic imaging showed a subdural hematoma. Should this be reported on the MDS as a fall with major injury?

Q: Is this a Fall with Major Injury? A resident had an unwitnessed fall and self-reported that she hit her head. No injuries or concerns were noted upon post-fall evaluations. Three days later, the resident was transferred to the hospital due to chest pain and...

Ask Proactive – I am seeking assistance for accurate coding of CVA at item I4500 of the MDS. The physician acknowledges history of stroke in his progress note during the look-back period. The patient also receives daily aspirin and requires ongoing medication management for stroke prevention, nurses monitor for potential side effects from medication including signs & symptoms of bleeding and bruising. Would this meet the criteria to code active condition CVA at I4500?

Q: I am seeking assistance for accurate coding of CVA at item I4500 of the MDS. The physician acknowledges history of stroke in his progress note during the look-back period. The patient also receives daily aspirin and requires ongoing medication management for stroke...

Ask Proactive – I would like to code isolation for a resident who has COVID and was in single room isolation for 4 days in the look-back period. However, the therapy documentation reports 2 episodes of the resident walking in the hallway. Can we still code isolation?

Q: I would like to code isolation for a resident who has COVID and was in single room isolation for 4 days in the look-back period. However, the therapy documentation reports 2 episodes of the resident walking in the hallway. Can we still code isolation?   A:...

Ask Proactive – Do you recommend including concurrent therapy in your POC & rationale? For group tx, there is a separate CPT code. Many therapists may provide concurrent tx later in the plan of care when patient is safer.

Q: Do you recommend including concurrent therapy in your POC & rationale?  For group tx, there is a separate CPT code.  Many therapists may provide concurrent tx later in the plan of care when patient is safer.   A: Modes of Therapy are outlined in Chapter 3...