News / Blog

Need to brush up on the latest industry news? Look no further! Proactive Medical Review consultants provide up-to-date blog postings to keep you in the know.

The latest news, events, blogs and more…

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 &...

read more

Person-Centered Care Planning

“Person-centered”, “Individualized”, “Resident-focused”; whatever you may call it, it’s past time to evolve from the institutionalized, staff-focused care planning we’ve become accustomed to and embrace the requirement that the individual has control over their life...

read more

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...

read more

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...

read more

PDPM Coding Questions – What would happen if the interrupted stay criteria was met, but the resident came back from the hospital with a new diagnosis?

Q: What would happen if the interrupted stay criteria was met, but the resident came back from the hospital with a new diagnosis?   A: In order to utilize Medicare benefits, even if the criteria of the Interrupted Stay Policy have been met, the resident must...

read more

PDPM Coding Questions – I have NPO resident on tube feeding. He coughed during trials of nectar thick liquids per speech therapy. Should the MDS be coded for swallow problems?

Q: I have NPO resident on tube feeding. He coughed during trials of nectar thick liquids per speech therapy. Should the MDS be coded for swallow problems? The RD says directions on the MDS RAI manual say “do not code if interventions are successful in treating...

read more

Visit our Store for Recordings, Templates, Trainings and more...