Tag: coding

CMS issues ICD-10 split claims billing instructions

CMS issued a MLN Matters article that offers instructions that clarify the policy for processing claims for certain institutional encounters that span the ICD-10 implementation date of October 1, 2014. Skilled Nursing Facilities (Inpatient Part B): Bill type: 22X Use FROM date Require providers split the claim so all ICD-9 codes remain on one claim […]

CMS releases updated MDS 3.0 RAI User’s Manual

The Centers for Medicare & Medicaid Services (CMS) recently released the RAI Manual v1.10 Replacement Manual Pages and Change Tables and the RAI Manual v1.10 and Change Tables. MDS 3.0 RAI Manual v1.10 Appendix B was also updated. The updated MDS 3.0 RAI Manual v1.10 was effective May 8, 2013. This version of the MDS […]

Ask the expert: Therapy billing

Q: We did an M5/d/c/SOT on a resident that was admitted on 3/6 and discharged on 3/7. All therapies were treated on the last day. Here is some more information: ADL RUG IV score: 3 PT: 60 min OT: 60 min ST: 25 min Total: 145 min We submitted and then received fatal error ID […]

Ask the expert: Coding music therapy minutes

Q: When coding music therapy minutes in O0400F, can I include minutes for group therapy with four or less in the group, or can I only code individual minutes? The assessment, physician order, and care plan are all in place. A: The only information I could find on this is contained in the MDS 3.0 […]

Ask the expert: Change of therapy and assessment reference date

Q: A change of therapy (COT) is for the date February 5. I thought I opened it in the software. Can I open this assessment on February 14 and complete it that day without taking a default, and is there a time limit? A: I’m assuming from your question that February 5 should have been […]

ICD-10-PCS introduces procedure guidelines and coder confusion

Currently we only have a little advice when it comes to coding procedures using ICD-9-CM Volume 3 codes, and most of that comes from AHA Coding Clinic. So I was really excited to see that the cooperating parties developed guidelines with the new ICD-10-PCS system. However, once I began studying them, I noticed some guidelines […]

Ask the expert: Hospice coding

Q: If someone is on Hospice and a hospice worker gives that person a bath, which they do in our building, we were instructed that we cannot take credit for it on the MDS—so would we code it not assessed? Doesn’t make much sense, being that it is not one of the late loss ADLs […]

Ask the expert: Nystatin coding

Q: Is Nystatin coded in MDS 3.0 Section N as an antibiotic? And is it pharmacological classification vs. therapeutic classification? A: The pharmacological classification is the determining factor in making a coding decision.

Ask the expert: Coding for an unstageable area

Q: A resident is admitted with a cast on leg in October, cast removed on 12/5/12, noted with an unstageable area on ankle. How do we code it on the MDS? A: When the MDS is completed, if the pressure ulcer is still unstageable, then that is how it should be coded on the MDS.