by Proactive Medical Review | Mar 3, 2021 | PDPM Coding Questions
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:...
by Proactive Medical Review | Feb 24, 2021 | PDPM Coding Questions
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...
by Proactive Medical Review | Feb 17, 2021 | PDPM Coding Questions
Q: What are the ARD, completion, and transmission requirements for the IPA? A: The ARD may be set for any day of the SF PPS stay, beyond the ARD of the 5-day assessment. The IPA must be completed within 14 days after the ARD (ARD+14 days). The IPA must be...
by Proactive Medical Review | Feb 10, 2021 | PDPM Coding Questions
Q: I have a resident with an active diagnosis of hyperglycemia who is receiving blood glucose monitoring and scheduled and sliding scale insulin during the 5-day assessment look-back period. Why is the NTA Case-mix Group NF (0 points)? A: Hyperglycemia alone is...
by Proactive Medical Review | Feb 3, 2021 | 5 Star, PDPM Coding Questions
Q: What time periods are reflected in the current 5-Star Rating that was updated Jan. 2021? A: The Jan. 2021 refresh includes data for the following: Health Inspections – Your current health inspection rating includes data from your last 3 recertification...
by Proactive Medical Review | Jan 27, 2021 | PDPM Coding Questions
Q: In order for us to capture in room isolation for our COVID positive residents, what is needed for supportive documentation? Also, is there a length of time this resident has to be in isolation in order to capture it? A: The resident must have an “active”...