Q: I have a patient that has 100 days of Medicare Part A and a percutaneous endoscopic gastrostomy (PEG) tube—the primary source of nutrition—in place since 2008 due to laryngeal cancer. All rehab therapy is discontinuing in three days. Can I continue Medicare Part A, related to the PEG tube? A: As long as 26% […]
Brought to you by Biller’s Association for Long-Term Care. As SNF and nursing home providers familiarize themselves with CMS’ new Patient Driven Payment Model (PDPM), The Bottom Line is here to keep you educated and up to date on the latest resources, guidance, and best practices as they are made available. Here are this week’s […]
Since the implementation of PDPM on October 1, thousands of therapists have been laid off, reports Modern Healthcare. The payment system prior to PDPM, RUG-IV, allowed SNFs to bill therapy services they deemed necessary, but some took advantage by ordering superfluous therapy services to gain additional reimbursement from Medicare. PDPM seeks to stop this practice. […]
Q: We have a lot of questions in our facility about tube feeders and Medicare Part A eligibility. Here is one example: A person getting tube fed uses 100 days of their benefit, goes off Medicare Part A, has a 60 day break in illness, and was then readmitted to hospital with a hip fracture. He […]
Whether you are just beginning your career or are a veteran MDS coordinator, you play a pivotal role in managing the long-term care residents’ care.
CMS is staying true to plans to implement a new payment model. The 2020 PPS proposed rule, which was posted to the Federal Register July 11, reinforces the plan to implement the Patient-Driven Groupings Model (PDGM) beginning on or after Jan. 1, 2020. The model will move from 60-day episodes to 30-day payment periods. While […]
CMS has announced July 17 two new rules that, according to a CMS press release, will place more focus on SNF residents as a priority over paperwork by reducing unnecessary regulations and protecting their legal interests. The proposed rule would delay Phase 3 requirements, including QAPI and ethics and compliance standards. The final rule upends […]
Source: Home Health Line Ensure clinicians have proper training about how to respond to the OASIS-D item involving patients’ ability to dress their lower body safely. M1820 (Ability to dress lower body) is one of six OASIS items that affect functional case-mix adjustment under the PPS, and it will be one of eight items that […]
Coders will have new ICD-10-CM codes to report pressure-induced deep tissue damage, acute versus chronic embolism and thrombosis and fractures of the facial bones around the eye, among other changes. All told, 273 codes are proposed to be added, 30 codes revised and 21 invalidated in the ICD-10-CM code set for fiscal year 2020. The […]
One of our regulatory experts answers a question about the new End of Therapy OMRA clarifications and EOT-R OMRA provision included in the SNF PPS Final Rule for 2012.