Category: MDS 3.0 and the RAI Process

Question: A dialysis patient is going out of the facility for dialysis. We use the appropriate N18 code, but would Z99.2 be excluded since dialysis isn’t provided in-house? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The resident remains your SNF’s resident while receiving dialysis. Coding should reflect the …

Question: We have a patient who is on hospice but elected to be sent out over the weekend for an acute illness, so he revoked his hospice status. He came back less than 24 hours later. If he is picked back up on hospice within the next day or two, …

Question: If a resident has a fall that causes a hairline clavicle fracture, is that automatically considered a major injury? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC:Yes, any traumatic fracture related to a fall is a fall with major injury—even a finger or toe. This AAPACN resource is …

Question: A resident’s last therapy day was on 3/5. He didn’t go home until the afternoon of the next day, 3/6. Can I combine the OBRA Discharge and the PPS Discharge assessments, or since the last covered day and physical discharge are different days, do they need to be done …

Question: A resident’s wheelchair tipped backward in therapy. The physical therapy assistant was able to catch him, but it resulted in a skin tear to the arm. The resident remained in the wheelchair and did not come to rest on the ground. Should this be coded as a fall? Answer …

Question: A resident on a Medicare Part A stay was sent to the emergency department by ambulance at 6:45 p.m. on Feb. 2 and returned to the facility just after midnight without being admitted to the hospital. Would this situation qualify as an interrupted stay? Answer from Jeff Taylor:The interrupted …