SNF QRP: SNF Discharge Function Score Technical Report

This report presents the Discharge Function Score measure specifications. Section 2 provides an overview of the measure and a high-level summary of the key features of the measure that are described in detail in the remaining sections of the document. Section 3 describes the methodology used to construct the Discharge …

CMS Section GG Training Videos: GG0130A, GG0110, GG0170C, GG0130B, Decision Tree for GG0130/GG0170

Video Tutorials Available to Assist with Coding Specific Section GG Items The Centers for Medicare & Medicaid Services is releasing a series of short videos to assist providers with coding select Section GG items on the OASIS, IRF-PAI, LTCH CARE Data Set, and the MDS. These videos, ranging from 4-12 …

Medicare Medical Review Contractors Overview

Since the Medicare program is heavily monitored for improper payments to protect the Medicare Trust Fund, it is likely your facility will experience a medical review by a Medicare contractor. The AAPACN Medicare Medical Review Contractors Overview tool provides a summary of the different types of Medicare contractors that may …

Q&A: We have a resident that is in our facility for skilled services under Medicare Part A. The family took the resident out for a funeral, and she did not return within 24 hours. Is this a Medicare Part A discharge?

Question: We have a resident that is in our facility for skilled services under Medicare Part A. The family took the resident out for a funeral, and she did not return within 24 hours. Is this a Medicare Part A discharge? Answer from Jeff Taylor: This would not be a …

COVID-19 Diagnosis Flow Chart for FY 2023

The complexities of assigning codes for COVID-19 and associated manifestations can be a confusing process. The AAPACN COVID-19 Diagnosis Flow Chart tool uses chapter-specific coding guidance for FY 2023 and will assist the user to ensure all appropriate diagnoses are considered when using the ICD-10-CM coding manual for final code …

Payroll-Based Journal (PBJ) Audit Tool

The Centers for Medicare & Medicare Services (CMS) requires PBJ data to be submitted at least quarterly. It is imperative that this data is accurate as it is publicly reported and impacts the Five Star rating, is included in the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program for fiscal …

SNF VBP Online Resources

CMS has an online home for the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program that offers multiple resources explaining how the program works. Landing page: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/SNF-VBP/SNF-VBP-Page.html Spotlights & Announcements Scoring Methodology & Payment Adjustment Confidential Feedback Reporting & Review and Corrections Extraordinary Circumstance Exception Public Reporting of SNF VBP …

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

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, …