Question: I am a relatively new DNS and my job description includes overseeing the Therapy Department. Is this within my scope? Answer: In most SNFs, the therapy department usually has its own director/manager, with ultimate oversight by the administrator. But in smaller facilities, such as yours, sometimes those oversight roles are shared. …
Question: Does anyone have an ‘International Dysphagia Diet Standardization Initiative’ policy? Answer: The IDDSI framework has many resources and guidance on how to implement the framework. https://iddsi.org/framework/ Consider convening a meeting with the dietitian, ST, dietary manager, and the rep from your food service company to discuss use and implementation. …
Question: When I received training for ICD-10 coding as it relates to billing, I was taught that the primary diagnosis code for long term SNF residents on a UB-04 claim would be their primary diagnosis for why they remain in the nursing facility. Therefore, if the primary diagnosis code was …
Question: Are we responsible for dental appointments (toothache) on our Medicare Part A residents or does the dentist bill the family? Answer: Dental coverage is not part of the Medicare Part A program, so the cost is also not the facility’s responsibility. In other words, there is no dental money …
Question: I understand that the diagnosis in I0020B should be listed as the principal diagnosis on the UB-04 claim; however, should the remaining diagnoses be listed in order according to the main reasons the resident is skilled how we list the codes in I8000, to include the codes that are …
Question: This situation seems to be happening at my facility more and more. When residents pass away at the facility and do not have a funeral home listed, how long (hours) are we able to keep the body? I have family members who seem to think that they can call …
Question: Does the primary diagnosis that physical therapy and occupational therapy use need to match the primary ICD-10 code used by nursing? Answer: Often confusion stems from the terms used across different disciplines. Therapists use medical and treatment diagnoses, while the SNF uses other terms, such as admission diagnosis, …
Question: Under RUG-IV PPS, if the resident returns to a skilled level of care within 30 days the reason for skilled care would have to be something that was present/treated during the first qualifying hospital stay or developed during the skilled period. How does that work with PDPM and the Interrupted …
Question: We have a resident who is independent with eating during the day, but also is total dependence for nightly tube feeding. Would a coding of extensive assist of one be correct? Answer: Please review the example in the RAI Manual on page G-11: Residents with tube feeding, TPN, …
Question: Do we need to report to ombudsman if a short-term resident was sent out to the hospital for change of condition? Answer: No, not unless the change of condition was due to an unusual occurrence. Interested in reading more FAQs? Visit the AADNS Network where you can review questions …
