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 – Is it correct that CNA’s are not allowed to complete section GG? Is it possible to have CNAs submit documentation to an RN who then completes the assessment for GG?
Q: Is it correct that CNA's are not allowed to complete section GG? Is it possible to have CNAs submit documentation to an RN who then completes the assessment for GG? A: As per the RAI - assess the resident’s self-care and mobility performance based on direct...
10 Tips for a Better Medicare Meeting
With focus primarily on successful implementation of the Patient Driven Payment Model (PDPM) in recent months, now is a good time to revisit the importance of a solid process for the Medicare Meeting, or Utilization Review Meeting. Under PDPM, some providers have...
PDPM Coding Questions – When should the comprehensive care plan be completed if you are submitting MDS’ day 14 as best practice?
Q: When should the comprehensive care plan be completed if you are submitting MDS' day 14 as best practice? A: As per regulation - a comprehensive care plan must be developed within 7 days after completion of the comprehensive assessment (Admission, Annual, or...
New Part B Therapy NCCI PTP Edits Effective January 1st
Hindsight is 20/20… this is something that comes to mind when taking a deep dive into the new and unforeseen National Correct Coding Initiative (NCCI) procedure to procedure (PTP) edits that were effective January 1, 2020. Without any warning, Capitol Bridge, LLC,...
PDPM Coding Questions – Is a pacemaker placement considered a major enough surgery to use the “aftercare following surgery on the circulatory system” code?
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: Is a pacemaker placement considered a major enough surgery to use the “aftercare following surgery on the circulatory system” code? A: It would generally be...
PDPM Coding Questions – Which reimburses more: the orthopedic or neurological clinical category?
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: Which reimburses more: the orthopedic or neurological category? A: In most cases, the orthopedic pays more. In some cases, as when the resident also has...
Reducing Missed Non-Therapy Ancillary (NTA) Opportunities
When reviewing the CMI components driving PDPM reimbursement it’s important to consider the critical role of the Non-Therapy Ancillary (NTA) score. The NTA component score is based on the presence of certain comorbidities and/or the use of extensive services. CMS...
Insights on New Draft Version of 2020 MDS Item Sets
The Centers for Medicare & Medicaid Services (CMS) announced that a new DRAFT version of the 2020 MDS item sets (v1.18.0) has been posted. The most impactful change was removing Section G from all Federal item sets. This will help eliminate the coding...
PDPM Coding Questions – If a resident discharges and returns from an interrupted stay do we start over on the Medicare certification?
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: If a resident discharges and returns from an interrupted stay do we start over on the Medicare certification? A: If the resident qualifies for the interrupted...
PDPM Coding Questions – Does the Primary diagnosis code entered at I0020B also need to be entered as an active diagnosis at I8000?
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: Does the Primary diagnosis code entered at I0020B also need to be entered as an active diagnosis at I8000? A: Yes, per the RAI guidelines for coding I0020, it...
PDPM Coding Questions – We have a new Part A skilled admission who was treated during qualifying hospital stay. What should we do in this situation?
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: We have a new Part A skilled admission who was treated for dehydration, weakness, and nausea during qualifying hospital stay. There are no other diagnosis...
Do you have necessary Policies & Procedures in place for PDPM Compliance?
Join our 2020 Webinar Series! If you’re like most facilities, you’ve spent the past year training staff, improving coding practices and updating interdisciplinary meetings to incorporate the many changes brought with the onset of PDPM. But have you included a review...
Some of our favorite recipes to ring in the New Year…
To celebrate the New Year, we thought it would be fun to share some of our favorite recipes. We hope you and your family will enjoy trying these delicious treats together in 2020! Recipe by Amie Martin, OTR/L, CHC, RAC-CT, Proactive Medical Review Hot Spinach...
PDPM Coding Questions – Why aren’t the Nursing and NTA components reflecting the MDS report?
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs. Q: We reported on the MDS that a resident received IV medications in the hospital within the look-back period. Why aren’t the Nursing and NTA components reflecting...
Support Nurse Retention With Targeted Professional Development
Targeted vs. Targeting Nursing staff have undergone a major change with the transition to PDPM creating an added stressor to an already demanding job. Opportunities for professional development have been found to be a key retention factor contributing to career...
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