ICD-10-CM Codes: Use of Unspecified Codes Resulting in Medicare Denials

Billing and Reimbursement / NAC / Podcast

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN, Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, and Carol Maher, RN-BC, RAC-MTA, RAC-MT, CPC, director of education for Hansen, Hunter & Co., P.C./Synergy Healthcare Resources/Axiom/HealthBridge, …

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Interrupted Stay Flow Chart

Billing and Reimbursement / NAC / Tool

Determining whether an interrupted stay has occurred can be a challenge, especially when so many different factors must be considered. AAPACN’s enhanced  Interrupted Stay Flow Chart will help nurse assessment coordinators (NACs) navigate different scenarios to assist in the determination of whether an interrupted stay has occurred or not. For permission …

Medicare A2400C Algorithm with the NPE and Interrupted Stay

Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC / Tool

AAPACN has adapted the A2400C flow chart from section A of the RAI User’s Manual to show how A2400C impacts how the nurse assessment coordinator (NAC) schedules the PPS Part A Discharge assessment and how the interrupted stay policy could impact both A2400C and the assessment schedule. Check out AAPACN’s …

AAPACN Responds to CMS’s Comment Request for FY 2023 SNF PPS Proposed Rule

Advocacy / Article / Billing and Reimbursement / NAC / Workforce Solutions

Jessie McGill, RN, RAC-MT, RAC-MTA and Alexis Roam, MSN, RN-BC, DNS-CT, QCP The annual rulemaking process enables stakeholders to comment on proposals that will affect skilled nursing facilities (SNFs) throughout the next year. In early April, the Centers for Medicare & Medicaid Services (CMS) issued its fiscal year (FY) 2023 …

Q&A: Does an inpatient rehab stay count toward a qualifying hospital stay for Medicare coverage?

Billing and Reimbursement / NAC / Q&A

Question: We have a referral for a resident with Medicare Part A who has been in an inpatient rehab facility (IRF) for six weeks. Is the IRF still considered acute and can qualify for the 3-day qualifying hospital stay (QHS)? Answered by Janine Cortesa RN, BSN: Acute inpatient rehab facilities …

Resident Cognitive Level Determination: For the SLP and Nursing Components Under PDPM

Billing and Reimbursement / NAC / Tool

If the BIMS interview is not completed, the PDPM Cognitive Level will be used to determine cognitive impairment under the SLP and Nursing components of PDPM. AAPACN has updated its Resident Cognitive Level Determination Tool to help nurse assessment coordinators better understand the differences between SLP and Nursing PDPM Cognitive Level scoring.  For permission to …

SNF VBP: FY 2026 Program Year Proposed Nurse Staffing Measure Technical Specifications (4/22)

Administrator / Billing and Reimbursement / DNS / Post-Acute Care News / QAPI and Quality Initiatives

Proposed Specifications for the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program: Total Nursing Hours per Resident Day Measure (PDF) From https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/SNF-VBP/Measure