Tag: medical necessity

Assessing medical necessity and homebound status of psychiatric patients

Medical Necessity The proof of medical necessity strictly relies on the MD documentation and diagnosis and the SN’s clinical documentation during evaluation, on routine nurse’s notes, and on recertification. This is why the use of standardized tools and specific psychiatric addendum notes is an important part of the patient’s evaluation and treatment in continuing to […]

Ask the expert: Medicare coverage

Q: A resident in a SNF has not used her Medicare benefit since 2005. She was receiving rehab therapy 5x week prior to qualifying for a hospital stay. Are we allowed to skill her upon re-admission? A: Your question cannot be answered without more information.  Did the beneficiary ever go 60 days without receiving skilled […]