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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…

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...

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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:...

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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...

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Ask Proactive – 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)?

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...

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Ask Proactive – 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?

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”...

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Ask Proactive – With the extension of the PHE effective January 21st, can we expect the 5-star rating related to Quality Measures to remain “frozen”?

Q: With the extension of the PHE effective January 21st, can we expect the 5-star rating related to Quality Measures to remain “frozen”?   A: No. In December, CMS announced quality measures posted to the Care Compare website and used in the Five Star Quality...

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